Test #2 - common sonographic findings

Tubular ectasia of rete testis

hypoechoic, small cystic spaces

Dilated tubules appear avascular and fluid filled on Col Dop

Yolk sac tumor

inhomogeneous

echogenic foci

Choriocarcinoma

heterogenous mass

calcifications

acute epididymitis

enlarged, hypoechoic epididymis head, increased flow

Chronic Epididymitis

thickened echogenic epididymis, calcifications

epididymitis

Cryptorchidism (Undescended testis)

Prostate carcinoma (Adenocarcinoma)

 ‘beak” where seminal vesicles enters central zone

70 % Peripheral zone, 20% transition, 1-5% central

varicocele

greater than 2 mm

Preform valsalva for increased flow in prominent veins

Scrotal hernia

Look for peristalsis

fluid-filled loops

Benign prostatic hyperplasia (BPH)

transitional zone

Hydrocele

anechoic fluid, calcifications with posterior shadowing

hematocele

focal mural calcification

spermatocele

 round or oval anechoic mass, no posterior enhancement 

orchitis

Torsion “bell clapper deformity”

enlarged epididymis and testicle

No blood flow

Leydig Cell tumor

non-germ cell

benign leydig cell tumor

solid, well-circumscribed intratesticular mass

Less than 1 cm

Peripheral flow

malignant leydig cell tumor

hypoechoic

greater than 5 cm

seminoma

 Well-defined, solid, hypoechoic mass

Homogeneous echotexture 

 Hypervascularity on color Doppler in tumors larger than 1.6 cm

lymphoma

 enlargement of testes

 Decreased echogenicity diffuse or focal

 Increased vascularity 

 

Peyronie’s Disease

 Plaque is dense hyperechoic area near peripheral margin

 Calcifications with or w/o shadow

Microlithiasis

 1-3 mm echogenic foci