SONOGRAPHIC FINDINGS IN TUBERCULOUS EPIDIDYMITIS AND EPIDIDIMOORCHITIS

Purpose. This paper presents the sonographic findings in scrotums of p atients affected with tuberculous epididymitis or epididymo-orchitis. Methods. Eighteen patients with a total of 22 abnormal hemiscrotums (4 patients had bilateral lesions) underwent scrotal sonography. Patholo gic confirmation was obtained via epididymectomy in 10 cases, epididym o-orchiectomy in 7 cases, and scrotal exploration and biopsy in 3 case s, The histopathologic diagnosis was tuberculous epididymitis in 12 ca ses and epididymo-orchitis in 8 cases, Results. Lesions involved the h ead of the epididymis in 8 cases, the rail in 5 cases, and the entire epididymis in 9 cases. The enlarged epididymis was hypoechoic in 13 ca ses, hyperechoic in 2 cases, and of mixed echogenicity in 7 cases. The echotexture was heterogeneous in 17 cases and homogeneous in 5 cases. Testicular involvement in 7 cases appeared as a diffusely enlarged hy poechoic testis in 2 cases, an ill-defined hypoechoic lesion in 1 case , a well-demarcated hypoechoic lesion in 2 cases, and multiple small h ypoechoic nodules in an enlarged testis in 2 cases. Hydrocele, sinus t ract, and extratesticular calcifications were seen in 12, 4, and 2 cas es, respectively. Conclusions. The heterogeneous and hypoechoic swelli ng of the epididymis or the concomitant hypoechoic lesion of the testi s with associated sinus tract or extratesticular calcifications may be helpful in the diagnosis of tuberculous epididymitis or epididymo-orc hitis, especially in patients with known genitourinary tuberculosis. ( C) 1997 John Wiley & Sons, Inc.