Clinical Radiology (2007) 62, 1019
CORRESPONDENCE RE: The testes: the unusual, the rare and the bizarre SirdI read with interest the recent, highly informative review article relating to unusual conditions involving the testes and their ultrasound appearances.1 As the authors correctly state testicular sarcoidosis is rare and most commonly manifests sonographically as discrete focal hypoechoic intratesticular lesions. However, this sonographic appearance may not be the only sonographic manifestation of testicular sarcoidosis as demonstrated in a recent case seen in our department. A 28year-old male patient commencing treatment for known thoracic sarcoidosis presented with bilateral testicular swelling and associated ache. High-resolution ultrasound was performed of the testes, which confirmed the testes to be symmetrically enlarged and hypoechoic, with heterogeneity and coarsening of the testicular echo-texture also apparent (Fig. 1).
The testes were hypervascular on colour Doppler assessment. In the context of known active sarcoidosis these appearances were felt to be in keeping with testicular involvement of this systemic disease. The testicular swelling and ache and thoracic symptoms have subsequently improved with continuing treatment, and in view of this, confirmatory biopsy has not been undertaken.
Reference 1. Stewart VR, Sidhu P. The testes: the unusual, the rare and the bizarre. Clin Radiol 2007;62:289e302.
D.C. Howlett Eastbourne District General Hospital, Eastbourne, UK E-mail address: [email protected]
Figure 1 Longitudinal sonogram of the right testis demonstrates marked coarsening of the testicular echo-texture with the testis also appearing generally hypoechoic. Similar sonographic appearances were also identified within the contralateral testis. 0009-9260/$ - see front matter ª 2007 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.crad.2007.05.009