P45: Vascular features of testicular tumours at Color Doppler US: Specific features for recognizing lymphoma.

Purpose: In testicular lymphoma, tumor cells grow infiltrating through the tubules and through the normal testicular vessels, and the normal vascular architecture of the testis is preserved. wether the macroscopic appearance is nodular or diffus. The aim of this study is to describe the grey-scale and Doppler findings in testicular lymphoma, and to evaluate whether identification at color Doppler ultrasound of testicular vessels with straight course crossing a mass in improving characterization of the lesion. Materials and Methods: A cohort of 21 patients with testicular mass underwent scrotal Doppler ultrasound within the period between June 2012 and May 2014. Color Doppler images were available were reexamined to assess the features of the lesion, either mass forming or diffuse, and presence of normal testicular vessels with straight course crossing the lesion. Results: Thirteen patients with pathologically-proven lymphoma were found, five patients were carrying another histological type and 3 patients in whom lymphoproliferative disease was suspected on clinical and US ground and pathology or clinical evolution showed non-neoplastic disease. Lymphoma patients age ranged 21-72 y (median: 64 y). Eight patients had primary disease and one had testicular involvement in sistemic disease. None had bilateral involvement. Patients with non neoplasic lesions (three patients) had proven non-specific inflammation (n = 1), granulomatous orchitis (n = 1) and tuberculosis (n = 1). Involvement of the testis was focal in six patients with lymphoma, diffuse in the others. Color Doppler US demonstrated normal testicular vessels with straight course within the tumor in the nine cases of lymphoma. Conclusion: In patients over 60 and/or with history of lymphoproliferative disease presenting with a testicular mass lymphoma must be considered; Demonstration of normal testicular vessels crossing the lesion is a useful adjunctive criterium to confirm the diagnosis. Inflammatory lesions may present the same imaging features as lymphoma. These criterias should be researched by the radiologist to predict eventually the kind of tumour as preoperative approach. [ABSTRACT FROM AUTHOR]