De Cinque Antonio, Corcioni Beniamino, Rossi Martina Sofia, Franceschelli Alessandro, Colombo Fulvio, Golfieri Rita, Renzulli Matteo, Gaudiano Caterina
Department of Radiology, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Urology, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Front Med (Lausanne). 2021 Jan 27;7:610384. doi: 10.3389/fmed.2020.610384. eCollection 2020.
Sarcoidosis is a multisystemic disease histologically characterized by non-caseating epithelioid granulomas and multinucleated giant cells; the etiology is still uncertain, and likely related to a complex interplay between environmental and genetic factors. The genitourinary system is affected in fewer than 0.2% of all clinically diagnosed cases of sarcoidosis and in 5% of those identified in autopsy studies. In this report, we describe a case of a 42-year-old male with one hypoechoic lesion per testis on B-mode evaluation; contrast-enhanced ultrasound (CEUS) on both lesions was carried out. During the early phase, the masses showed a hypovascular appearance as compared to the surrounding testicular tissue, maintaining the hypo-enhancement in the late phase. Tissue biopsy for pathological evaluation confirmed testicular sarcoid involvement, showing non-caseating granulomas. Allowing visualization of testicular microvascularisation, CEUS may play an important role in excluding malignancy, avoiding unnecessary aggressive treatment for benign conditions, such as sarcoidosis. A review of the literature of reported cases since 2004 of sarcoidosis involving the testis is also included.
结节病是一种多系统疾病，组织学特征为非干酪样上皮样肉芽肿和多核巨细胞；其病因仍不确定，可能与环境因素和遗传因素之间的复杂相互作用有关。在所有临床诊断的结节病病例中，泌尿生殖系统受累的比例不到0.2%，而在尸检研究中发现的病例中这一比例为5%。在本报告中，我们描述了一例42岁男性，B超评估显示每个睾丸有一个低回声病变；对两个病变均进行了对比增强超声（CEUS）检查。在早期阶段，与周围睾丸组织相比，肿块表现为低血供，在晚期阶段仍保持低增强。组织活检进行病理评估证实睾丸结节病累及，显示非干酪样肉芽肿。CEUS能够显示睾丸微血管情况，在排除恶性肿瘤、避免对结节病等良性疾病进行不必要的积极治疗方面可能发挥重要作用。本文还对2004年以来报道的累及睾丸的结节病病例文献进行了综述。
