[Differential diagnosis of palpable changes in scrotal content. Specificity and sensitivity of high resolution B-scan...

In 96 patients in urological treatment the 10 MHz high resolution B-scan sonography proved to be a valuable complement to inspection, palpation and diaphanoscopy. A distinction between testicular, extratesticular, cystic and solid lesions could be made with great reliability. Masked testicular neoplasia associated with hydroceles testis and epididymitis can be detected earlier with sonography. However, great care must be taken when differentiating benign from malign changes in the testicles and epididymis. Testicular neoplasia, focal orchitis, testicular abscess and chronically inflamed tumours of the epididymis have a similarly lowered echogenicity and a tumour-like picture. Focal areas of increased testicular echogenicity in all cases represented benign calcifications, fibrosis or cicatricial tissue. Operative exploration is obligatory when the dignity of the lesion is unclear.