Brown D L, Benson C B, Doherty F J, Doubilet P M, DiSalvo D N, Van Alstyne G A, Vickers M A, Loughlin K R
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
AJR Am J Roentgenol. 1992 Jun;158(6):1257-9. doi: 10.2214/ajr.158.6.1590118.
We reviewed the scrotal sonograms of 31 patients who had a testicular mass consisting of multiple small spherical or tubular anechoic structures in the region of the mediastinum testis. The median age of the patients was 62 years (range, 31-76 years). The abnormality was unilateral in 22 patients and bilateral in nine. Thirty-four (85%) of the 40 involved testicles had coexisting epididymal abnormalities: 32 with epididymal cysts and two with epididymitis. Follow-up sonograms were available in five patients and showed no change up to 4.5 years after the initial diagnosis. Surgical and histologic findings were available in one other patient and showed dilatation of the rete testis. The sonographic appearance and location of the lesions, the frequent presence of an epididymal abnormality, and the surgical and histologic findings in one case suggest that the lesion is due to dilatation of the rete testis, probably associated with obstruction in the epididymis. Recognition of this entity on sonograms may prevent unnecessary orchiectomy.
我们回顾了31例睾丸纵隔区域存在由多个小球形或管状无回声结构组成的睾丸肿块患者的阴囊超声图像。患者的中位年龄为62岁（范围31 - 76岁）。22例患者的异常为单侧，9例为双侧。40个受累睾丸中的34个（85%）存在附睾异常：32例有附睾囊肿，2例有附睾炎。5例患者有随访超声图像，初诊后长达4.5年未见变化。另有1例患者有手术和组织学检查结果，显示睾丸网扩张。病变的超声表现和位置、附睾异常的常见存在以及1例患者的手术和组织学检查结果提示，该病变是由于睾丸网扩张，可能与附睾梗阻有关。在超声图像上识别这一实体可能会避免不必要的睾丸切除术。
