Scrotal Pathology

Cryptorchidism - description

Undescended testicle, most likely in the inguinal canal, increased chance of malignancy and infertility

Cryptorchidism - ultrasound

mispositioned testicle situated anywhere it shouldn’t be, increased echogenicity

Torsion - description

Twisting of the spermatic cord cutting off blood supply to the testicle, most common in patients 12-18, requires surgical treatment within 4-6 hours

Torsion - ultrasound

enlarged, heterogenous testicle, hypovascularity

Epididymitis - description

most common cause of acute scrotal pain, sexually transmitted, fever, chills, heaviness of affected testicle, pelvic pain, urinary issues

Epididymitis - ultrasound

Enlarged epididymis, increased vascularity

Orchitis - description

Inflamation of the testicle due to trauma or infection, usually occurs with epididymitis, acute pain without fever

Orchitis - ultrasound

Decreased echogenicity, increased size, calcifications, affected testicle is smaller

Hydrocele - description

Abnormal collection of fluid between layers of tunica vaginalis, painless scrotal swelling

Hydrocele - ultrasound

Anechoic fluid within scrotum

Tubular ectasia of the rete teste - description

Dialation of the ductules, enlargement of the rete testis, common post-vasectomy

tubular ectasia of the rete teste - ultrasound

cluster of hypoechoice small cystic spaces within/next to the mediastinum testis

Varicocele - descritpion

Collection of dialated veins, incompetent valves, most common on left side becasue it drains in the left renal vein

Varicocele - description

Tubular structures greater than 2mm in diameter

Scrotal hernia - description

Inguinal hernia that enters the scrotum, persistent scrotal mass, abd pain, blood in stool

Scrotal hernia - ultrasound

Mass that may contain air or fluid filled loops of bowel, peristalsis

Microlithaisis - description

calcification, associated with an increased risk of malignancy

Microlithiasis - ultrasound

multiple 1-3mm echogenic foci in thesticle, bilaterally

Scrotal pearl - description

calcifications on the tunica vaginalis, result of inflamation or long standing inflection

Scrotal pearl - ultrasound

echogenic free floating calculus, posterioir shadowing

Seminoma - description

most common type of testicular neoplasm, undesended testes, found in patients with microlithaisis

Seminoma - ultrasound

well defined, solid, hypoechoic mass, homogenous, hypervascularity

Yolk sac tumor - description

80% of childhood testicular tumors, most occur before age 2

Yolk sac tumor - ultrasound

nonspecific appearance, usually heterognous

Choriocarcinoma - description

rare form of germ cell cancer, 20-30, worst prognosis

Choriocarcinoma - ultrasound

heterogenous mass, mixed ecogenicity

PBH - description

enlargement of the prostate due to nodular formation in the transition zone, narrorwing of urethra, urinary issues

PBH - ultrasound

heteronenous, potential for calcifications

Prostate cancer - description

most common cancer in american men, peripheral zone, mimics BPH, blood in urine, back pain, weakness, weight loss

Protate cancer - description

hypervascularity in the peripheral zone, indistinct buling margin of tumor

Prostatitis - description

Inflammation of the prostate

Prostatitis - ultrasound

enlargement of gland, increased vascularity

Peyronies - description

fibrosis of the sheath covering the corpus cavernosa, unknown cause in men over 45

Peyronies - ultrasound

hyperechoic thickeing ner the peripheral margin of the corpus cavernosa