Ultrasonographic detection of epididymal sarcoidosis

Abstract

Sarcoidosis clinically involves the genital system in only 0.5% of the cases. Autopsy series report a 4.5% incidence of genital sarcoid~sis.'-~ To our knowledge we are reporting the 23rd histologically proven case of epididymal sarcoidosis and the second report of its sonographic appearancce. CASE REPORTA 20-year-old black male presented with a fourmonth history of right scrotal swelling, and with a two-month history of productive cough and increasing dyspnea. He had had five prior episodes of gonococcal urethritis, which resolved with treatment.

Sonographic appearance of testicular sarcoid.

“…Most urogenital system involvement is limited to the kidneys.2 In those persons with involvement of the male genital tract, 70% of cases involve the epididymis, and most of the remainder are isolated to the testis. Concomitant testicular and epididymal sarcoid, as noted in this case, has been reported to be rare.t, 6 Of the approximately 20 cases of male genital tract sarcoidosis reported to date, many were incidental autopsy findings,3 and most have been described prior to the advent of ultrasonography. 4 In three cases in which sonographic examples of testicular sarcoid have been published, the following spectrum of findings was noted: two small hypoechoic lesions in the left testicle in a patient with testicular maldescent on the right side,4 numerous hypoechoic foci scattered throughout both testicles and epididymides,1 and a solitary echogenic solid mass involving the entire right epididymis and cephalad aspect of the ipsilateral testicle.2 A CDU image in the lastmentioned case demonstrated a vascular appearance to the mass.…”

Epididymitis: Diagnosis and treatment

“…Tipično se javlja progresivno zahvatanje epididimisa, koje je obostrano u oko 30% oboljelih [29]. Ultrazvučni nalaz je različit, ali se često vidi povećan heterogen epididimis, koji može da sadržava različite čvoriće [30][31][32]. Liječenje kortikosteroidima uklanja bol i otok i trebalo bi da se provede prije nego se donese odluka о hirurškoj eksploraciji skrotuma [33].…”