Which condition may present as irregular, hypoechoic solid mass in the testicle and can be diffuse?

Which condition may present as irregular, hypoechoic solid mass in the testicle and can be diffuse?

• A. Adenomatoid
• B. Sarcoidosis
• C. Varicocele
• D. Spermatic granulomas

Answer: (B)

In ultrasound evaluation of the testicle, a mass that is irregular and hypoechoic and can be diffuse points toward an inflammatory or granulomatous process rather than a straightforward tumor. Sarcoidosis is a systemic granulomatous disease that can involve the testicular parenchyma, producing either focal nodules or a diffuse, heterogeneous, hypoechoic appearance. Because it can mimic neoplasms, recognizing the possibility of sarcoid involvement is important, especially if there are known systemic signs (pulmonary sarcoidosis, hilar lymphadenopathy) or compatible lab data. Adenomatoid tumors are typically located in the epididymis and appear as small, well-defined, often solid lesions adjacent to the testis rather than intratesticular and irregular. Varicocele represents dilated veins of the pampiniform plexus, which on ultrasound look like tortuous, anechoic channels with venous flow, not a solid hypoechoic mass. Spermatic granulomas usually present as nodules related to the epididymis or the vas deferens, not as irregular intratesticular diffuse masses. So the finding of an irregular, hypoechoic solid intratesticular area that can be diffuse best fits sarcoidosis, reflecting testicular granulomatous involvement.

In ultrasound evaluation of the testicle, a mass that is irregular and hypoechoic and can be diffuse points toward an inflammatory or granulomatous process rather than a straightforward tumor. Sarcoidosis is a systemic granulomatous disease that can involve the testicular parenchyma, producing either focal nodules or a diffuse, heterogeneous, hypoechoic appearance. Because it can mimic neoplasms, recognizing the possibility of sarcoid involvement is important, especially if there are known systemic signs (pulmonary sarcoidosis, hilar lymphadenopathy) or compatible lab data.

Adenomatoid tumors are typically located in the epididymis and appear as small, well-defined, often solid lesions adjacent to the testis rather than intratesticular and irregular. Varicocele represents dilated veins of the pampiniform plexus, which on ultrasound look like tortuous, anechoic channels with venous flow, not a solid hypoechoic mass. Spermatic granulomas usually present as nodules related to the epididymis or the vas deferens, not as irregular intratesticular diffuse masses.

So the finding of an irregular, hypoechoic solid intratesticular area that can be diffuse best fits sarcoidosis, reflecting testicular granulomatous involvement.