title: Granulomatous epididymo-orchitis: sonographic features and clinical outcome in brucellosis, tuberculosis and idiopathic granulomatous epididymo-orchitis.
abstract: OBJECTIVE
  We reviewed and analyzed sonographic findings in granulomatous epididymo-orchitis in an attempt to differentiate this rare inflammatory entity from other causes of enlarged scrotum, such as tumors.
  
  
  METHODS
  We retrospectively reviewed sonographic features of 9 patients a mean of 41 years old with specific and nonspecific granulomatous epididymo-orchitis, including brucellosis in 7, tuberculosis in 1 and idiopathic granulomatous epididymo-orchitis in 1. Histological confirmation was obtained in 3 cases, and in the remaining 6 positive clinical manifestations and laboratory tests for brucellosis were accepted as the main criteria for the diagnosis of brucellar epididymo-orchitis.
  
  
  RESULTS
  The most notable echographic finding was an enlarged and heterogeneous epididymis, predominantly in the body and tail. Testicular involvement consisted of a diffusely hypoechoic testis or focal intratesticular areas. Thickening of the scrotal wall and tunica albuginea, and moderate hydrocele were also noted occasionally. Followup scans revealed intratesticular abscesses in 3 patients.
  
  
  CONCLUSIONS
  These echographic findings may suggest the diagnosis of granulomatous epididymo-orchitis in the appropriate clinical setting, and help to avoid unnecessary orchiectomy for benign disease.
authors.affiliation: Hospital Príncipe de Asturias, Alcalá de Henares, Albacete, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Salmeron
authors.forename: M A
authors.initials: MA
authors.lastname: Ramirez-Escobar
authors.forename: F
authors.initials: F
authors.lastname: Puertas
authors.forename: R
authors.initials: R
authors.lastname: Marcos
authors.forename: F
authors.initials: F
authors.lastname: Garcia-Marcos
authors.forename: R
authors.initials: R
authors.lastname: Sanchez
mesh_terms: D000328:Adult; D002006:Brucellosis / Q000150:complications; D004823:Epididymitis / Q000000981:diagnostic imaging* / Q000209:etiology; D006099:Granuloma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies; D012611:Scrotum / Q000000981:diagnostic imaging*; D014376:Tuberculosis / Q000150:complications; D014463:Ultrasonography