Granulomatous epididymo-orchitis: sonographic features and clinical outcome in brucellosis, tuberculosis and idiopathic granulomatous epididymo-orchitis.
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.
Salmeron
I
I
Hospital Príncipe de Asturias, Alcalá de Henares, Albacete, Spain.
Ramirez-Escobar
M A
MA
Puertas
F
F
Marcos
R
R
Garcia-Marcos
F
F
Sanchez
R
R
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