Ultrasonic appearances of epididymal spermatic granuloma

Abstract

Objective To explore the relationship between ultrasonic appearances of epididymal spermatic granuloma and its pathologic characteristics. Methods The sonographic features of 32 cases of epididymal spermatic granuloma confirmed by pathology were retrospectively analyzed. Results A total of 34 epididymal spermatic granuloma nodules in 32 cases included 4 located in caput epididymidis and 30 located in cauda epididymidis, and maximum diameter of nodules were about 0.5-2.3 cm. Sonographic and pathologic appearances of nodules were: ①mostly low echo type, 21 nodules mostly showed the obscure boundary and quite abundant blood flow signals, early granulomas formed with interstitial fibrosis inapparently under-microscope; ②inhomogeneous echo type, 12 nodules mostly showed the barely clear boundary and blood flow signals from small amount to abundant amount, granulomas of different maturites distributed dispersedly with interstitial fibrosis of varying degrees under-microscope or single giant lesions formed; ③mostly high echo type, 1 nodule showed the obscure boundary and inapparent blood flow signals, center of the nodules distributed by a large amount of dense fibrous tissue under-microscope. Anechoic ethmoid sinus seen in 29 nodules was section of dilated epididymal ductus. Dotted strong echoes seen in 6 nodules were calcification of sperms in dilated epididymal ductus and necrotic tissue. Conclusions Ultrasonic appearances of epididymal spermatic granuloma are closely related to its pathologic characteristics. To recognize both relations contributes to improve the diagnostic value of ultrasound. Key words: Ultrasonography; Spermatic Granuloma; Epididymis