GRANULOMATOUS EPIDIDIMOORCHITIS - SONOGRAPHIC FEATURES AND CLINICAL OUTCOME IN BRUCELLOSIS, TUBERCULOSIS AND IDIOPATHIC GRANULOMATOUS EPIDIDIMOORCHITIS

Purpose: We reviewed and analyzed sonographic findings in granulomatou s epididymo-orchitis in an attempt to differentiate this rare inflamma tory entity from other causes of enlarged scrotum, such as tumors. Mat erials and Methods: We retrospectively reviewed sonographic features o f 9 patients a mean of 41 years old with specific and nonspecific gran ulomatous epididymo-orchitis, including brucellosis in 7, tuberculosis in 1 and idiopathic granulomatous epididymo-orchitis in 1. Histologic al confirmation was obtained in 3 cases, and in the remaining 6 positi ve clinical manifestations and laboratory tests for brucellosis were a ccepted as the main criteria for the diagnosis of brucellar epididymo- orchitis. Results: The most notable echographic finding was an enlarge d and heterogenous epididymis, predominantly in the body and tail. Tes ticular involvement consisted of a diffusely hypoechoic testis or foca l intratesticular areas. Thickening of the scrotal wall and tunica alb uginea, and moderate hydrocele were also noted occasionally. Followup scans revealed intratesticular abscesses in 3 patients. Conclusions: T hese echographic findings may suggest the diagnosis of granulomatous e pididymo-orchitis in the appropriate clinical setting, and help to avo id unnecessary orchiectomy for benign disease.