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Reproductive Sonography > Scrotal Cysts > Flashcards

Scrotal Cysts Flashcards

1
Q

What is a spermatocele

A

Fluid-filled sac that grows in the head of the epididymis

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2
Q

Spermatoceles contain

A

Thick milky fluid

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3
Q

What is in the thick milky fluid in spermatoceles

A

Spermatozoa
Lymphocytes
Cellular debris

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4
Q

What are the sonographic findings of spermatoceles

A

Anechoic/hypoechoic
Head of epididymis
Posterior acoustic enhancement
Low-level echoes

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5
Q

What are differentials of spermatoceles

A

Varicocele
Hydrocele
Epididymal cyst

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6
Q

Varicocele is engorged

A

Spermatic cord veins

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7
Q

What does an epididymal cyst contain

A

Clear serous fluid

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8
Q

Spermatocele is difficult to differentiate form an epididymal cyst except for ____ since

A

Aspiration since a spermatocele contains milky-appearing sperm

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9
Q

Testicular cysts may be caused by

A

Cancer
Fibrosis
Epididymal cysts

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10
Q

What are the symptoms of testicular cysts

A

Swelling
Lesions
Inflammations
Probelms during ejaculation

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11
Q

What are the sonographic findings of a testicular cyst

A

Criteria for simple cyst
(Anechoic, thin walled, posterior enhancement)

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12
Q

What are the differentials of a testicular cyst

A

Mature cystic teratoma
Tubular ectasia of Rete Testis
Intratesticular Abscess

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13
Q

What is tubular ectasia/Rete testis

A

Partial or complete obliteration of efferent ducts

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14
Q

What is a intratesticular abscess secondary to

A

Epididymyo-orchitis

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15
Q

Tubular ectasia or rete testis occurs in patients ___
Occurs ____ (Bilateral or unilateral)

A

55+ years old
Bilateral

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16
Q

Where are simple scrotal cysts usually located

A

Common in mediastinum testis

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17
Q

What is an epididymal cyst contain

A

Serous liquid

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18
Q

Where is the most common place for an epididymal cyst

A

Mostly over head of epididymis

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19
Q

Epididymal cysts are lined with ____ and contains

A

Epithelium
Contains clear serous fluid

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20
Q

What is an epidermoid cyst

A

Noncancerous small bumps beneath the skin

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21
Q

Where are the most common places for epidermoid cysts

A

Face
Neck
Trunk
Scrotum

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22
Q

What are the sonographic findings of an epidermoid cyst

A

“Target/Bull’s Eye” pattern
Confined to tunica albuginea
“Onion skin”

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23
Q

What are the differentials of an epidermoid cyst

A

Tunica albuginea cyst
Germ cell tumor
Testicular granuloma

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24
Q

What is scrotoliths

A

Scrotal pearls
Benign macro-calcifications (Stones in scrotum)

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25
Q

T or F:
In scrotoliths there is clinical significance

A

False
Usually no clinical significance

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26
Q

What are the main causes of microlithiasis

A

Unknown but sometimes associated with testicular cancer

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27
Q

In microlithiasis there is multiple small

A

Calcifications

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28
Q

What are the sonographic findings for microlithiasis

A

Discrete, small, echogenic foci within testicle
1-3mm
No posterior shadowing

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29
Q

What are the differentials for microlithiasis

A

Scrotal pearls
Large-cell calcifying sertoli cell tumor
Testicular granuloma

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30
Q

Varicoceles is dilated veins in the
It is due to

A

Pampiniform plexus of spermatic cord
Due to venous reflux

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31
Q

Varicoceles is due to retrograde flow in

A

Internal spermatic vein

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32
Q

Varicocele happens most commonly on the ___(Right or Left) side

A

Left

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33
Q

What is the most common sign of varicoceles

A

Infertility

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34
Q

What is the most common reversible cause of male infertility

A

Varicoceles

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35
Q

What are the sonographic findings of varicoceles

A

Scanned upright and supine
Multiple hypoechoic, serpiginous tubular structures
Superior and lateral to testis

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36
Q

Sonographically the diameter of the plexus veins in varioceles is approx.

A

> 2-3 mm

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37
Q

What is the rule fo 3’s

A

3 veins>3mm

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38
Q

In varicoceles there’s the enlargement of veins with

A

Valsalva maneuver

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39
Q

In varicoceles there is retrograde color with

A

Valsalva

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40
Q

What are the differentials of varicoceles

A

Tubular ectasia/Rete testis
Testicular torsion
Epididymitis

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41
Q

T or F:
Flow does not change with valsalva in epididymitis

A

True

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42
Q

95% of testicular tumors are

A

Malignant germ cell tumors

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43
Q

Testicular carcinomas originate from

A

Reproductive (Sperm producing) tissue

44
Q

What are the types of germ cell tumors

A

Nonseminomatous germ cell tumor
Seminoma

45
Q

T or F:
Nonseminomatous germ cell tumors are less aggressive than seminoma

A

False
Is more aggressive

46
Q

What is the most common type of germ cell tumor

A

Seminoma

47
Q

What is a seminoma

A

Malignant germ cell tumor

48
Q

A seminoma most commonly involves the ___
Less frequently in

A

Common - Testicle
Less - Mediastinum, retroperitoneum, extra-gonadal sites

49
Q

Seminoma is ____ growth, ___ invasion, and ___ prognosis

A

Slow growth, late invasion, good prognosis

50
Q

Embryonal carcinomas usually happen in what decades

A

2nd & 3rd decade

51
Q

Choriocarcinoma usually happen in what decades

A

2nd & 3rd decade

52
Q

What is the least common testicular carinoma

A

Choriocarcinoma

53
Q

Choriocarcinoma is a ___ growth, ____ invasion, and ___ prognosis

A

Rapid growth, rapid invasion, bad prognosis

54
Q

Choriocarcinomas may produce

A

Human chorionic gonadotropin and gynecomastia

55
Q

What is a teratoma

A

Epidermoid cyst

56
Q

Teratomas are ____ (Malignant or Benign), ____ childhood (Early or late), to ___ decade

A

Benign, early childhood, 3rd decade

57
Q

Seminomas are malignant tumors of the

A

Testis

58
Q

What is the most common testicular tumor

A

Seminoma

59
Q

What are the types of seminoma

A

Classic
Typical
Spermatocystic

60
Q

Seminoma is a counterpart of dysgerminoma of the _____

A

Ovary

61
Q

What are the clinical findings of seminoma

A

Elevated beta - hCG, AFP
Palpable mass
Painless

62
Q

What are the sonographic findings of a seminoma

A

Well-defined
Hypoechoic
Solid
No calcifications or tunica invasion

63
Q

What is a teratoma/teratocarcinoma

A

Type of testicular cancer affecting the germ cells of sperm

64
Q

What are the sonographic findings of a teratoma/teratocarcinoma

A

Well-defined
Anechoic/Complex hetergenous mass
Cystic areas, calcifications

65
Q

What are embryonal cell carcinomas
What do they give a rise to

A

Malignant growth made up of epithelial cell
Rise to metastases

66
Q

Embryonal cell carcinomas are a form of cancer that makes up the majority of the cases of malignancy in

A

Breast
Uterus
Intestinal tract
Skin
Tongue

67
Q

Embryonal cell carcinoma is a _____ (Common or uncommon) type of germ cell tumors that occurs in

A

Uncommon
In ovaries and testes

68
Q

What is the average age of diagnosis of embryonal cell carcinomas

A

31

69
Q

Embryonal cell carcinomas are ____ (Nonaggressive or Aggressive) germ cell tumors

A

Aggressive

70
Q

For embryonal cell carcinoma the peak incidence occurs in people of what age

A

30 years

71
Q

What are more common sites for metastasis

A

Retoperitoneum
Lung
Liver

72
Q

What are the sonographic findings of an embryonal cell carcinoma

A

Heterogenous
Perdominately solid
Mixed echogenicity
Poorly marginated
Coarse calcifications
Invase TA & distort testicular contour

73
Q

Uncommon form of germ cell tumor
Usually about -% of tumors

A

Choriocarcinoma
1-3%

74
Q

Choriocarcinoma peak at what age

A

Young adult males

75
Q

What are the lab values for choriocarcinoma

A

Elevated serum beta hCG

76
Q

What is clincal findings of a choriocarcinoma

A

Patients with history of cryptorchidism have increased risk of testicular cancer

77
Q

What are the sonographic findings of a choriocarcinoma

A

Complex echo pattern
Hemorrhage
Necrosis
Calcifications

78
Q

What are the differentials of a choriocarcinoma

A

Epidermoid cyst
Lymphoma
Subacute hematoma

79
Q

Gonadal stromal tumors also known as non-germ cell, interstitial or sex cord tumors

A

Stromal tumors

80
Q

Gonadal germ cell tumor ___ & ___ in repro organs

A

Start & stays

81
Q

Stromal tumors originate in

A

Intersititial cells

82
Q

What is the most common form of stromal tumors

A

Leydig

83
Q

What are the 4 types of stromal tumors

A

Leydig
Sertoli
Granulosa cell
Gonadoblastoma

84
Q

Sertoil stromal tumors aise from

A

Cells lining seminiferous tubules

85
Q

What are granulosa cells

A

Rare benign tumor

86
Q

Gonadoblastoma contains both

A

Stromal and germ cell elements

87
Q

What is a Leydig cell tumor

A

Type of testicular cancer affecting the stromal cells of the testis

88
Q

What are Leydig cells

A

Structral and hormone producing cells of the testis

89
Q

What are stromal cells

A

Connective tissue or any organ

90
Q

Leydig cell tumor has decreased ____, ____, ____

A

Libido
Gynecomastia
Impotence

91
Q

Painless testicular enlargement

A

Leydig cell tumor

92
Q

__% of Leydig cell tumors are ______ (Malignant or Benign)

A

90% Benign

93
Q

What are the sonographic findings of Leydig cell tumors

A

Small solid hypoechoic intratesticular mass

94
Q

What are sertoli cell tumors

A

Sex cord-gonadal stromal tumor of sertoli cells

95
Q

Sertoli cell tumors occur in the

A

Testes or ovary

96
Q

Sertoli cell tumors are very ____ (Common or rare) and are usually between what ages

A

35-50

97
Q

What are the sonographic findings of sertoli cell tumor

A

Small hypoechoic mass

98
Q

Metastatic tumor is the same type of cancer as the _____ tumor

A

Primary

99
Q

What are the most common sites of metastasis in testicular cancer

A

Lymph nodes in lungs and abdomen

100
Q

In metastatic testicular tumors more ____ (Rarely or Commonly) the cancer spreads to the

A

Rarely
Bone, Liver, and Brain

101
Q

T or F:
All testicular masses should be considered malignant until proven otherwise

A

True

102
Q

Most malignancies are ____ (Hyperechoic or Hypoechoic) to normal testis

A

Hypoechoic

103
Q

Surgical removal of the skin covering the tip of the penis

A

Circumcision

104
Q

What are the health benefits of circumcision

A

Easy hygiene
Decreased risk of UTI’s, STI’s, & penile cancer
Prevent penile probelms

105
Q

Circumcision is not recommended if

A

Blood-clotting disorders
Premature babies
Babies born with abnormalities of the penis

106
Q

What are the risk of circumcision

A

Bleeding & Infection
Side affects related to anesthesia
Foreskin may be cut too short or long

Reproductive Sonography (9 decks)

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