CTICasesTesticular/Epididymal Sarcoidosis
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Imaging findings
Scrotal ultrasound in a patient presenting with painless swelling shows marked thickening and enlargement of the epididymis. Chest radiograph and CT scan reveal symmetric bilateral hilar and subcarinal lymphadenopathy with small, scattered lower-lung-predominant nodules. Scrotal biopsy confirmed the presence of non-necrotizing granulomas.
Key takeaways
Genitourinary involvement in sarcoidosis is exceedingly rare, with the epididymis and testes being the most common sites of disease in the pelvis, often mimicking epididymoorchitis or a testicular neoplasm. Radiologists should evaluate the chest for systemic signs of sarcoidosis when encountering atypical genitourinary masses to avoid unnecessary orchiectomy.
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