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疼痛性睾丸外病变的临床、影像学、细胞学及微生物学评估

Clinical, radiological, cytological, and microbiological assessment of painful extratesticular lesions.

作者信息

Agrawal Vivek, Jha Ashesh Kumar, Dahiya Devender

机构信息

Department of Surgery, University College of Medical Sciences and Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, India.

出版信息

Urol Ann. 2018 Apr-Jun;10(2):181-184. doi: 10.4103/UA.UA_62_17.

Abstract

INTRODUCTION

Most of the painful extratesticular scrotal lesions are erroneously diagnosed and treated in our clinical practice. Therefore, this study was undertaken to analyze the usefulness of a combination of clinical, radiological, cytological, and microbiological assessment in establishing the accurate diagnosis of this lesion.

AIM

To study the Clinical, Radiological, Cytological and Microbiological assessment of painful extra-testicular lesions and their correlation with each other in establishing the accurate diagnosis of these lesions.

OBJECTIVES

The objectives of the study were to assess the diagnostic significance of clinical, radiological, cytological, and microbiological methods and their correlation in establishing the accurate diagnosis of painful extratesticular lesions.

MATERIALS AND METHODS

This cross-sectional study was carried out in Departments of Surgery, Radiology, Pathology, and Microbiology, University College of Medical Sciences and GTB Hospital over the period of 2 years. During this period, we were able to accommodate 75 patients in the study, who presented with pain and swelling in the scrotum and clinically found to have extratesticular swellings. Radiological assessment was done on the 1 day of visit, using Grayscale ultrasonography along with Color Doppler of these lesions. For cytological assessment, ultrasound-guided fine-needle aspiration cytology and microbiological assessment were done from the aspirate remaining after making cytology slide.

STATISTICAL ANALYSIS

Data analysis was done using SPSS statistical software. Kappa statistics were used to find the degree of agreement or concordance between clinical, radiological, cytological, and microbiological findings.

RESULTS

Clinically 71 patients were found to have tender extratesticular swellings, whereas in four patients, these swellings were nontender on clinical examination. Radiologically, epididymitis was found in 32 patients. Only in 37 patients out of 75, a definite diagnosis could be made on cytology. The microbiological examination did not give any positive results.

CONCLUSION

Painful extratesticular scrotal lesion often poses a diagnostic dilemma in the mind of treating physician. Clinical findings of these lesions may be corroborated through radiological, cytological, and microbiological assessment in an endeavor to arrive at a definitive diagnosis with a defined etiology.

摘要

引言

在我们的临床实践中,大多数疼痛性睾丸外阴囊病变被误诊和误治。因此,本研究旨在分析临床、放射学、细胞学和微生物学评估相结合在准确诊断此类病变中的作用。

目的

研究疼痛性睾丸外病变的临床、放射学、细胞学和微生物学评估及其在准确诊断这些病变中的相互关系。

目标

本研究的目标是评估临床、放射学、细胞学和微生物学方法在准确诊断疼痛性睾丸外病变中的诊断意义及其相关性。

材料与方法

本横断面研究在医学科学大学学院和GTB医院的外科、放射科、病理科和微生物科进行,为期2年。在此期间,我们能够纳入75例患者进行研究,这些患者阴囊疼痛肿胀,临床检查发现有睾丸外肿胀。在就诊当天,对这些病变进行灰阶超声检查并结合彩色多普勒进行放射学评估。对于细胞学评估,在制作细胞学涂片后,对剩余的抽吸物进行超声引导下细针穿刺细胞学检查和微生物学评估。

统计分析

使用SPSS统计软件进行数据分析。使用Kappa统计量来确定临床、放射学、细胞学和微生物学检查结果之间的一致程度。

结果

临床上71例患者发现有疼痛性睾丸外肿胀,而4例患者在临床检查时这些肿胀无压痛。放射学检查发现32例附睾炎。75例患者中只有37例通过细胞学检查能明确诊断。微生物学检查未得出任何阳性结果。

结论

疼痛性睾丸外阴囊病变常常给治疗医生带来诊断难题。这些病变的临床发现可通过放射学、细胞学和微生物学评估得到佐证,以努力明确病因并做出明确诊断。

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本文引用的文献

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Primary adenocarcinoma of the epididymis: case report and review of the literature.
Urology. 1998 Nov;52(5):904-8. doi: 10.1016/s0090-4295(98)00275-1.
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Incision of the external inguinal ring in acute epididymitis.急性附睾炎时腹股沟外环切开术。
Br J Urol. 1973 Oct;45(5):555-8. doi: 10.1111/j.1464-410x.1973.tb06821.x.

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