TESTICULAR MICROLITHIASIS - IMAGING APPEARANCES AND PATHOLOGICAL CORRELATION

PURPOSE: To determine the spectrum of sonographic findings, clinical i mplications, and pathologic correlation in patients with testicular mi crolithiasis (TM). MATERIALS AND METHODS: The cases of 42 patients wit h the characteristic appearance of TM on sonograms were retrospectivel y evaluated for the number, pattern, and distribution of echogenic foc i and for associated intratesticular abnormalities. Medical records an d pathologic reports were reviewed. RESULTS: Considerable variation wa s found in the number and distribution of occurrences of TM (five to 6 0 echogenic foci per transducer field). In some patients, peripheral c lustering was seen. Most patients demonstrated side-to-side symmetry, but asymmetric distribution was seen in eight patients and unilateral foci were seen in one patient. In 17 patients, a germ cell neoplasm wa s seen. One additional patient had a focal lesion that was proved to b e an infarct. CONCLUSION: TM has a characteristic sonographic appearan ce. Because of the 40% occurrence of primary testicular neoplasm in as sociation with it, TM cannot continue to be considered a benign findin g.