Young man in his thirties presented with primary infertility. Having never had a prior scan of his scrotum, take a look at the high resolution images acquired.
Multiple < 3 mm sized well defined echogenicities without posterior shadowing are seen diffusely scattered throughout both testes. No abnormal clustering of these echoes.
So what are these testicular hyper reflective lesions? We don’t encounter these that often in clinical practice.
Basically accumulation of calcium within the lumen of seminiferous tubules results in this diffuse pattern called testicular microlithiasis.
All throughout our training, my knowledge of association has been oh.. microlithiasis … we should follow up for malignancy? Is that the case really?
Read this article that sheds some light on how we can follow up these patients.
Learning point: Look out for abnormal clustering of these calcifications. That could spell trouble (malignancy).