Lymphoma of the testis and epididymis mimics chronic inflammation upon sonography

Yang, Dal Mo; Kim, Hyun Cheol; Jin, Wook; Lee, Hyung Lae; Kim, Gyo Young

doi:10.1002/jcu.20536

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…This “striated pattern” was also described in later case reports on testicular lymphoma 28 and testicular infiltration of acute leukemia 18 . On color Doppler sonography, all reports noted markedly increased vascularity in patients with testicular lymphoma 9 , 17 , 22 , 24 , 26 – 29 …”

supporting

confidence: 59%

Straight Vessel Pattern and Rapid Filling Time

Lock¹,

Schmidt²,

Schröder³

et al. 2016

J of Ultrasound Medicine

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Six patients with 7 lesions that were histologically confirmed as primary testicular lymphoma were preoperatively investigated with a standardized sonographic protocol including contrast-enhanced sonography. Duplex and contrast-enhanced sonography showed marked hypervascularization in all 7 lesions. On contrast-enhanced sonography, the filling time of lymphomatous lesions was significantly shorter than the filling time of a size-matched sample of 10 patients with seminomas (P < .0001). The sonographic hallmarks of testicular lymphoma in our case series were as follows: (1) sharply demarcated homogeneous hypoechoic testicular lesions with marked hypervascularization; (2) a rapid (<7 seconds) filling time of contrast bubbles; and (3) a straight and parallel course of intralesional vessels on contrast-enhanced sonography.

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supporting

confidence: 59%

Straight Vessel Pattern and Rapid Filling Time

Lock¹,

Schmidt²,

Schröder³

et al. 2016

J of Ultrasound Medicine

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“…To our knowledge, there are four reports 3,12,14,18 of testicular lymphoma presenting as epididymo-orchitis. In another report by Mazzu et al, 11 one patient had enlarged hypervascular epididymis but the presence of epididymal inflammation without histological correlation was suggested.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Familiarity with US features of testicular lymphoma will help to differentiate lymphoma from other germ cell tumours or inflammation and provide appropriate management. Since reports of US features of testicular lymphoma remain limited, 3,[7][8][9][10][11][12][13][14][15][16][17][18][19] we reviewed the clinical presentation and US features of testicular lymphoma at our institution to add to the current knowledge.…”

Section: Introductionmentioning

confidence: 99%

Testicular Lymphoma: Clinical and Imaging Features

Pattamapaspong¹,

Khomarwut²,

Ya-In³

et al. 2016

Hong Kong J Radiol

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Objective: To review the clinical presentation and imaging features of testicular lymphoma. Methods: We retrospectively reviewed the clinical data, and grey-scale and colour Doppler ultrasound features of 11 patients with proven testicular lymphoma between January 2000 and September 2013. The patients were aged 35 to 84 years (mean, 59 years). The diagnosis was established by orchidectomy in eight patients, by compelling evidence including bone marrow and lymph node biopsy in two, and autopsy in one. Results: Of the 11 patients, seven presented with painless scrotal mass(es), three presented with an afebrile painful scrotal mass, and one presented with a febrile painful scrotal mass. Disease was unilateral in nine patients and bilateral in two. Primary testicular lymphoma was diagnosed in six patients and secondary testicular lymphoma in five, of which nine were non-Hodgkinʼs lymphoma with diffuse large B-cell lymphoma (DLBCL) and two were T-cell lymphoma. Ultrasonography revealed diffuse hypoechoic involvement in seven patients, a solitary hypoechoic mass in two patients, and bilateral multiple hypoechoic masses in two patients. All lesions showed hypervascularity. Enlarged epididymis with hypervascularity was present in two patients mimicking epididymoorchitis. Conclusion: Testicular lymphoma is predominantly DLBCL. Patients may present with painless or painful scrotal mass(es). Lymphoma should be considered in a man older than 50 years who presents with testicular mass regardless of pain with focal or diffuse hypervascular hypoechoic testicular lesion(s) on ultrasound. The associated hypervascular enlarged epididymis does not exclude the diagnosis of testicular lymphoma.

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Epididymal lymphoma: report of two cases and imaging findings

et al. 2013

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Epididymal lymphoma is a very rare tumor that is difficult to differentiate radiologically from other paratesticular tumors. Most cases of epididymal lymphoma are secondary involvement of the epididymis in patients with testicular lymphoma. However, isolated epididymal lymphoma is very rare. We herein report two cases of isolated epididymal lymphoma with different imaging findings. Patient 1 was a 52-year-old man who presented with a painless scrotal mass. Patient 2 was a 65-year-old man who presented with painless scrotal swelling. Ultrasound (US) demonstrated different imaging findings: US in patient 1 showed a well-defined round mass in the tail of the epididymis with hypervascularity confined to the epididymis, while US in patient 2 showed diffuse infiltrative enlargement with hypervascularity confined to the epididymis. Orchiectomy performed in both patients revealed diffuse large B-cell lymphoma confined to the epididymis.

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Lymphoma of the testis and epididymis mimics chronic inflammation upon sonography

Cited by 6 publications

References 8 publications

Straight Vessel Pattern and Rapid Filling Time

Straight Vessel Pattern and Rapid Filling Time

Testicular Lymphoma: Clinical and Imaging Features

Epididymal lymphoma: report of two cases and imaging findings

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