Woodward Paula J, Schwab Cornelia M, Sesterhenn Isabell A
Department of Radiologic Pathology, Armed Forces Institute of Pathology, 14th and Alaska NW, Bldg 54, Rm M-121, Washington, DC 20306-6000, USA.
Radiographics. 2003 Jan-Feb;23(1):215-40. doi: 10.1148/rg.231025133.
The extratesticular scrotal contents consist of the epididymis, spermatic cord, and fascia derived from the embryologic descent of the testis through the abdominal wall. As opposed to intratesticular masses, most extratesticular masses are benign. Cystic masses (including hydroceles, epididymal cysts, and varicoceles) are easily diagnosed with ultrasonography (US) and are benign. Epididymitis is a common extratesticular lesion as well as the most frequent cause of an acute scrotum. It may be either acute or chronic and can be potentially complicated by epididymo-orchitis or scrotal abscess. Findings include epididymal enlargement, skin thickening, hydroceles, and hyperemia. The epididymis can also be affected by sarcoidosis, a noninfectious granulomatous disorder. The most common extratesticular neoplasms are lipomas (most often arising from the spermatic cord) and adenomatoid tumors (most often found in the epididymis). Despite their relative rarity, malignant neoplasms do occur and include rhabdomyosarcoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, mesothelioma, and lymphoma. These tumors are often large at the time of presentation. The US findings of solid masses are often nonspecific. Magnetic resonance imaging can be very helpful in the evaluation of some of these disorders, allowing for a more specific diagnosis in cases of lipoma, fibrous pseudotumor, and polyorchidism.
睾丸外阴囊内容物包括附睾、精索以及源于睾丸经腹壁胚胎性下降过程的筋膜。与睾丸内肿块不同，大多数睾丸外肿块是良性的。囊性肿块（包括鞘膜积液、附睾囊肿和精索静脉曲张）通过超声检查（US）很容易诊断，且为良性。附睾炎是常见的睾丸外病变，也是急性阴囊最常见的病因。它可分为急性或慢性，可能并发附睾睾丸炎或阴囊脓肿。其表现包括附睾肿大、皮肤增厚、鞘膜积液和充血。附睾也可受结节病影响，这是一种非感染性肉芽肿性疾病。最常见的睾丸外肿瘤是脂肪瘤（最常起源于精索）和腺瘤样瘤（最常位于附睾）。尽管相对罕见，但确实会发生恶性肿瘤，包括横纹肌肉瘤、脂肪肉瘤、平滑肌肉瘤、恶性纤维组织细胞瘤、间皮瘤和淋巴瘤。这些肿瘤在出现时通常较大。实性肿块的超声表现往往不具特异性。磁共振成像在评估其中一些疾病时非常有用，对于脂肪瘤、纤维性假瘤和多睾症病例可进行更具特异性的诊断。
