Kachramanoglou Carolina, Rafailidis Vasileios, Philippidou Marianna, Bertolotto Michele, Huang Dean Y, Deganello Annamaria, Sellars Maria E, Sidhu Paul S
Department of Radiology, King's College Hospital, London, England.
Department of Pathology, King's College Hospital, London, England.
J Ultrasound Med. 2017 Feb;36(2):409-420. doi: 10.7863/ultra.16.02013. Epub 2016 Dec 29.
Primary testicular lymphoma is rare and appears with nonspecific findings on grayscale and color Doppler sonography. We present 8 patients further examined with contrast-enhanced sonography, strain elastography, and histologic analysis after orchiectomy. Seven of 8 patients had a diagnosis of large B-cell lymphoma, and 1 of 8 had a diagnosis of granulocytic sarcoma, with solitary lesions (2 of 8), multiple lesions (3 of 8), or entire testicular involvement (3 of 8). Lesions appeared hypoechoic (7 of 8) or isoechoic (1 of 8), all with increased vascularity on color Doppler sonography and a nonbranching linear pattern of intratumoral vessels (7 of 8). Contrast-enhanced ultrasound (CEUS) confirmed this pattern and showed increased enhancement in all lesions. On strain elastography, all lesions were hard, with an elasticity score of greater than 4. Multiparametric sonography of testicular lymphoma identifies increased vascularity on color Doppler and contrast-enhanced ultrasound and increased lesion stiffness on strain elastography.
原发性睾丸淋巴瘤较为罕见，在灰阶和彩色多普勒超声检查中表现为非特异性结果。我们报告了8例患者，在睾丸切除术后进一步接受了超声造影、应变弹性成像和组织学分析。8例患者中有7例诊断为大B细胞淋巴瘤，1例诊断为粒细胞肉瘤，病变可为孤立性（8例中的2例）、多发性（8例中的3例）或累及整个睾丸（8例中的3例）。病变表现为低回声（8例中的7例）或等回声（8例中的1例），在彩色多普勒超声检查中均显示血管增多，且肿瘤内血管呈非分支线性模式（8例中的7例）。超声造影（CEUS）证实了这种模式，并显示所有病变增强增加。在应变弹性成像中，所有病变均为硬，弹性评分大于4。睾丸淋巴瘤的多参数超声检查可发现彩色多普勒和超声造影显示血管增多，应变弹性成像显示病变硬度增加。
