Scrotal calcification: ultrasound appearances, distribution and aetiology

Bushby, L H; Miller, Fiona N. A. C.; Rosairo, Shantini; Clarke, Jon; Sidhu, Paul S.

doi:10.1259/bjr.75.891.750283

Cited by 67 publications

(48 citation statements)

References 7 publications

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“…2C,D), to the best of our knowledge, is a novel finding in a mutant mouse model and reminiscent of testicular microlithiasis in humans. Detected by testicular ultrasound, this rare condition in humans is characterized by multiple scattered echogenic foci (measuring 1-3 mm in diameter) within the testis (Bushby et al, 2002). These microliths are thought to form owing to severe seminiferous tubule damage and cell degeneration, although the etiology of this damage, and how or why they form, remains unknown.…”

Section: Discussionmentioning

confidence: 99%

RBPJ in mouse Sertoli cells is required for proper regulation of the testis stem cell niche

et al. 2014

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Stem cells are influenced by their surrounding microenvironment, or niche. In the testis, Sertoli cells are the key niche cells directing the population size and differentiation fate of spermatogonial stem cells (SSCs). Failure to properly regulate SSCs leads to infertility or germ cell hyperplasia. Several Sertoli cell-expressed genes, such as Gdnf and Cyp26b1, have been identified as being indispensable for the proper maintenance of SSCs in their niche, but the pathways that modulate their expression have not been identified. Although we have recently found that constitutively activating NOTCH signaling in Sertoli cells leads to premature differentiation of all prospermatogonia and sterility, suggesting that there is a crucial role for this pathway in the testis stem cell niche, a true physiological function of NOTCH signaling in Sertoli cells has not been demonstrated. To this end, we conditionally ablated recombination signal binding protein for immunoglobulin kappa J region (Rbpj), a crucial mediator of NOTCH signaling, in Sertoli cells using Amh-cre. Rbpj knockout mice had: significantly increased testis sizes; increased expression of niche factors, such as Gdnf and Cyp26b1; significant increases in the number of pre-and post-meiotic germ cells, including SSCs; and, in a significant proportion of mice, testicular failure and atrophy with tubule lithiasis, possibly due to these unsustainable increases in the number of germ cells. We also identified germ cells as the NOTCH ligand-expressing cells. We conclude that NOTCH signaling in Sertoli cells is required for proper regulation of the testis stem cell niche and is a potential feedback mechanism, based on germ cell input, that governs the expression of factors that control SSC proliferation and differentiation.

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Section: Discussionmentioning

confidence: 99%

RBPJ in mouse Sertoli cells is required for proper regulation of the testis stem cell niche

et al. 2014

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“…The typical US appearance has been described as multiple (generally accepted as more than five) small (1-3 mm) non-shadowing echogenic foci randomly scattered throughout the testicular parenchyma [1] . Acoustic shadowing is not seen, probably due to the small size of the calcifications [2] . It is generally accepted that TM consists of calcified cores surrounded by concentric layers of collagen fibers located in the lumen of the seminiferous tubules [3] .…”

Section: Introductionmentioning

confidence: 98%

“…Meanwhile, recent evidence in pediatric patients indicate that TM may consist of extratubular microcalcospherites associated with a double layer of Sertoli cells, which are probably related to the tubular basement membrane components that induce the development of an annular tubular pattern [4] . Although the exact causes of TM are not known, microliths may be re- lated to Sertoli cell dysfunction secondary to abnormal gonadal embryogenesis [2] .…”

Section: Introductionmentioning

confidence: 99%

Grading of Classical Testicular Microlithiasis Has No Effect on the Prevalence of Associated Testicular Tumors

Şanlı

Kadıoğlu²,

Atar

et al. 2008

Urol Int

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Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the prevalence of associated testicular tumors. Methods: Patients diagnosed with CTM using scrotal ultrasound over a 5-year period from a referral radiology clinic were included in this study. Patients with CTM were categorized as group 1 (grade I; 5–10 microliths/image), group 2 (grade II 10–20 microliths/image), and group 3 (grade III > 20 microliths/image). Other pathological findings were also recorded. The prevalence of testicular cancer was compared statistically between groups using the χ² test. Results: Seventy-eight of 4,310 (1.8%) patients were found to have CTM. Of these, 17 (21.7%) had ultrasonographically detected testicular cancer. In patients without CTM (n = 4,232), 58 (1.1%) testicular cancers were found. This accounted to a 19.7-fold increase in the detection rate of testicular cancer in patients with CTM compared to patients without CTM. The rates of testicular cancer detected in groups 2 and 3 were 25 (6/24) and 26.6% (4/15), respectively (p > 0.05), while it was 17.9% (7/39) in group 1. Conclusions: CTM is an uncommon incidental finding in patients undergoing testicular ultrasonography, and grading of CTM plays no role in the prevalence of testicular cancer.

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“…Testicular microlithiasis (TM) is characterized by the presence of echogenic foci within the testis parenchyma, measuring 1-3 mm in diameter, without shadowing (Bushby et al, 2002). TM is usually an asymptomatic finding at ultrasonography and is thought to be the result of microtubular damage, i.e.…”

Section: Introductionmentioning

confidence: 99%

Testicular microlithiasis in acquired undescended testis after orchidopexy at diagnosis

et al. 2013

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SUMMARYThe aim of this study was to observe the prevalence of testicular microlithiasis (TM) in surgically corrected acquired undescended testis (UDT). The prevalence of TM was assessed by ultrasound. Boys and young men who had undergone orchidopexy (ORP) for acquired UDT in mid or late childhood were observed to study the long-term testicular volume. During this examination, the presence or absence of TM was also assessed. TM was defined as echogenic foci without shadowing within the testis parenchyma. We included 106 patients who had undergone ORP at the Medical Center Alkmaar (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999) and 155 patients who had undergone ORP at the Juliana Children's Hospital (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009). The majority of patients were white, Caucasian (82%). The median age at followup, 25.8 years (range 14.0-31.6 years) was higher in Medical Center Alkmaar than in Juliana Children's Hospital 13.4 years (range 5.1-26.6 years). From 2009 to 2011, these 261 patients (median age 18.9 years) underwent an ultrasound examination. Median follow-up after ORP was 11.3 years (range 1.4-23.5 years); age at ORP ranged from 2.1 to 16.2 years, with a median of 8.5 years. TM was found in 17 (6.5%) patients (median age at follow-up 20.4 years; range 11-28). No significant association was found with the incidence of TM and the operated testis, the age at ORP or the racial variance (p > 0.05). ORP at diagnosis for acquired UDT is associated with a 6.5% prevalence of TM in boys and young adults.

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Scrotal calcification: ultrasound appearances, distribution and aetiology

Cited by 67 publications

References 7 publications

RBPJ in mouse Sertoli cells is required for proper regulation of the testis stem cell niche

RBPJ in mouse Sertoli cells is required for proper regulation of the testis stem cell niche

Grading of Classical Testicular Microlithiasis Has No Effect on the Prevalence of Associated Testicular Tumors

Testicular microlithiasis in acquired undescended testis after orchidopexy at diagnosis

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