Ultrasound of scrotum
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Atrophy Testicular atrophy may occur following cryptorchidism, inflammation, torsion, trauma, hypothyroidism, oestrogen treatment, liver cirrhosis, hypopituitary disease and ageing. The testis is globally reduced in size, usually unilateral with changes in testicular reflectivity related to the underlying cause, but usually of lower reflectivity (Figure 33). While volume and vascularity of the testis are reduced, the epididymis remains normal. Atrophy is a natural phenomenon of ageing where changes in the normal testis reflectivity, usually of a heterogeneous nature, may occur (82).
Figure 33 Testicular Atrophy. Testicular atrophy (arrow) in this spectacle view demonstrating a small low reflective testis.
Malignant focal lesions Malignant focal lesions are summarized in Table 2.
Table 2
CLASSIFICATION OF TESTICULAR TUMOURS Germ cell tumours Precursor lesions Intratubular germ cell neoplasia Tumours of one histological type Seminoma Classic Spermatocytic Embryonal carcinoma Yolk sac tumour Choriocarcinoma Teratoma Mature Immature With malignant transformation Tumours of more than one histological type Non-Germ cell tumours (Sex cord and stromal tumours) Leydig cell tumour Sertoli cell tumour Granulosa cell tumour