Bilateral synchronous granulomatous orchitis: gray-scale and colour Doppler sonographic findings

Idiopathic Granulomatous Epididymo-orchitis

“…The limited reports on color Doppler sonographic findings of granulomatous orchitis in 5 cases vary from hyperemia in the epididymis and testis in 2 cases 2 to peripheral low-resistance flow but no central flow in the areas of hypoechoic testicular infiltration in 1 case. 6 The sonographic appearance of our case is atypical in that a peripheral rim of residual normal tissue was present. This finding is most frequently seen with a malignant process such as seminoma or lymphoma and is less common in a benign process such as granulomatous orchitis.…”

“…2 However, idiopathic granulomatous orchitis may occur with or without epididymal involvement. 1,6 Other sonographic findings such as scrotal wall and tunica albuginea thickening, associated with inflammatory processes, are less frequently seen in granulomatous orchitis. 5 Associated ipsilateral or contralateral hydroceles, including a case of recurrent hydrocele after hydrocelectomy, have been reported.…”

Sonography of the Scrotum

“…Gray-scale US demonstrates an irregular hypoechoic infiltration of the testes, with increased blood flow at the periphery of the lesion but no flow into the lesion. Idiopathic granulomatous orchitis cannot be reliably distinguished from testicular malignancies, and a final diagnosis can only be confirmed with specimens from orchiectomy (158,159).…”

Orquitis granulomatosa idiopática bilateral

“…La ecografía tan efectiva en la patología del contenido escrotal, no es útil en el diagnóstico diferencial con los tumores malignos. No obstante la OG suele describirse como testículos difusamente hipocoicos con áreas focales intratesticulares pobre o bien definidas 4,5,14 . La histología suele presentar dos patrones anatomopatológicos característicos:…”

“…La combinación de la historia clínica junto el estudio de laboratorio y la ecografía nos pueden dar el diagnóstico 3,11,13 . Nosotros presentamos un raro caso de orquitis granulomatosa idiopá-tica con afectación sincrónica de ambos testículos, lesión bilateral con sólo 4 casos publicados en la literatura 4,6,7,10 .…”