Ultrasonic evaluation of the scrotum in lymphoproliferative disease.

Abstract

Scrotal ultrasound examinations of 23 male adults and children with the diagnosis of lymphoproliferative disease (LPD) were performed. Diagnoses included acute lymphoblastic leukemia (ALL) (six patients); acute myelogenous leukemia (AML) (one patient); chronic lymphocytic leukemia (CLL) (nine patients); non‐Hodgkin's lymphoma (four patients); Hodgkin's lymphoma (three patients). Sonography‐biopsy correlation was 100% in identifying testicular infiltrates. Nine of ten patients with testicular involvement had bilateral disease. Six patients had nonpalpable disease correctly identified by sonography. Ultrasound has great potential value as a screening modality for testicular biopsy in ALL and for detecting subclinical or nonpalpable disease in adults with LPD.

Ultrasonography Evaluation of Scrotal Masses

“…7). [35][36][37] In acute leukemia the testes are a common site of infiltration. A blood-testis barrier limits the effect of chemotherapeutic agents in general, with this phenomenon commonly described in pediatric acute lymphoblastic leukemia, allowing persistence of leukemic cells in the testes after remission.…”

Enlargement and hypervascularity of both the epididymis and testis do not exclude involvement with lymphoma or leukemia

“…Sonography also plays an important role in the diagnosis of scrotal involvement in patients with lymphoproliferative disease. 1 It may be difficult to differentiate diffuse lymphomatous or leukemic involvement of the testis from epididymo-orchitis by sonography, however. It has been suggested that testicular hypervascularity, without associated epididymal hypervascularity, is more suggestive of a neoplastic process than of orchitis.…”

Ultrasound-guided core-needle biopsy of the testis for focal indeterminate intratesticular lesions

“…Non-Hodgkin's lymphoma involves the testes in up to 20% and the testis may be the primary site [15]. The US appearances of testicular involvement with a haematological malignancy can be similar to more common primary testicular tumours.…”