Ecografía normal y patológica de escroto

1. Imagen Diagnóstica MEDICINA DE AVANZADA E S C R O T O Ecografía normal Dr.: CALIRI, Néstor 10 de febrero de 2009

16. Transverse US scan of the testis shows a normal transmediastinal artery (arrow) as a linear hypoechoic band. Color Doppler flow US (not shown) revealed flow through the vessel.

17. Imagen Diagnóstica MEDICINA DE AVANZADA E S C R O T O Ecografía patológica Dr.: CALIRI, Néstor 10 de febrero de 2009

18. N E O P L A S I A S M A L I G N A S

29. “ Tumor Fundido” fenómeno de "autoquemadura" supone la regresión de un foco de tumor testicular tras la producción de metástasis a distancia, sin conocerse su causa. A pesar de esto, podemos identificar lesiones histológicas características, como son la presencia de una lesión compuesta de tejido colágeno, con células neoplásicas dispersas en su interior. El diagnóstico se realiza mediante el estudio anatomopatológico de la pieza de orquiectomía, debiendo llevarse a cabo ésta en pacientes con tumor germinal extragonadal que presentan alteraciones en la exploración física o en la ecografía.

33. Tumor del seno endodermico mass. (a) Longitudinal US scan of the left hemiscrotum shows a solid tumor (T) replacing the entire testis. The cystic areas (arrowheads) represent tumor necrosis.

36. cystic mass (M) with echogenic borders and peripheral solid components (arrows). A rim of normal testis (T) is also seen

37. Mature teratoma in a 22-year-old man. (a) Longitudinal US image of the right testis shows a multilocular cystic mass. The cysts vary in appearance from anechoic to echogenic.

42. a) Longitudinal US image of the left testis shows a heterogeneous, predominantly hypoechoic mass, with scattered areas of hypoechogenicity (arrowheads). Normal testicular parenchyma is compressed peripherally by the tumor and contains diffuse microlithiasis (arrow). (b) Doppler US image shows normal peripheral vascularity with absence of central flow.

43. Longitudinal US image of the left testis shows a heterogeneous, predominantly hypoechoic mass, with scattered areas of hypoechogenicity (arrowheads). Normal testicular parenchyma is compressed peripherally by the tumor and contains diffuse microlithiasis (arrow). (b) Doppler US image shows normal peripheral vascularity with absence of central flow.

46. Figure 7. Sertoli cell tumour. Large smooth curvilinear calcification (curved arrow) at the periphery of a heterogeneous mass (open arrows).

49. Transverse US image of the left testis shows multiple hypoechoic lesions.

51. P A T O L O G I A B E N I G N A I N T R A T E S T I C U L A R

53. Tunica albuginea cyst in a 36-year-old man. (a) US image shows a small, peripherally located testicular lesion (arrow) with internal echoes. (b) On a coronal T2- weighted image, the lesion (arrow) is isointense relative to fluid. The lesion was isointense to fluid with all pulse sequences, a finding that confirmed its cystic nature. The presence of this pathognomonic finding obviated any further intervention.

54. Intratesticular cyst in a 50-year-old man. (a) US image shows a right-sided 17- mm-diameter intratesticular cyst. (b) T2-weighted image shows that the lesion (arrow) has the characteristic high signal intensity of fluid. The surrounding thin rim of testicular parenchyma enables diagnosis of an intratesticular cyst. However, note that there is some overlap in imaging appearances of an intratesticular cyst and a tunica albuginea cyst. No further intervention was performed.

57. Dilated rete testis in a 44-year-old man. (a) Sonogram shows multiple small, cystic or tubular, anechoic structures that replace and enlarge the testicular mediastinum. (b) On a T2-weighted image, the lesion has high signal intensity.

60. P A T O L O G I A B E N I G N A E X T R A T E S T I C U L A R

71. Intratesticular varicocele in a 38-year-old man. (a) Transverse oblique US scan of left testis reveals multiple intratesticular anechoic cystic areas (arrowhead). (b) Duplex Doppler US scan shows that venous flow in these cystic areas increases during a Valsalva maneuver (arrowhead).

72. E S C R O T O A G U D O

83. Image 1 (Ultrasound): Swelling of the right epididymis with associated mild right orchitis. Doppler images (not shown here) demonstrated increased vascularity.

88. F I N