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Testicular Leydig's Cell Hyperplasia: MR Imaging and Sonographic Findings

Laura R. Carucci1, A. Temel Tirkes1, E. Scott Pretorius1, Elizabeth M. Genega2 and Susan P. Weinstein1

1 Department of Radiology, University of Pennsylvania Medical Center, 1 Founders Pavilion, 3400 Spruce St., Philadelphia, PA 19104.
2 Department of Pathology, University of Pennsylvania Medical Center, Philadelphia, PA 19104.



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  		Fig. 1A. —44-year-old man with 1-year history of intermittent scrotal pain. Sonogram of right testicle reveals subcentimeter-size hypoechoic lesion (double arrows) in upper pole and smaller hypoechoic lesion (single arrow) in mid pole.

 


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  		Fig. 1B. —44-year-old man with 1-year history of intermittent scrotal pain. Black and white image from color-flow Doppler sonography shows color flow within lesion in upper pole of right testicle, indicative of vascularity.

 


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  		Fig. 1C. —44-year-old man with 1-year history of intermittent scrotal pain. Sagittal fat-suppressed fast spin-echo T2-weighted MR image (TR/TE, 4467/143) of right testicle shows two well-defined subcentimeter-size lesions (arrows) that are hypointense relative to testicular parenchyma. Small hydrocele may also be seen.

 


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  		Fig. 1D. —44-year-old man with 1-year history of intermittent scrotal pain. Coronal gadolinium-enhanced gradient-echo MR image (68/2.9) shows multiple subcentimeter-size lesions in right testicle (arrows). Lesions show mild enhancement.

 


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  		Fig. 1E. —44-year-old man with 1-year history of intermittent scrotal pain. Photomicrograph of section of right testicle reveals increased Leydig's cells in interstitium (black arrows) between normal seminiferous tubules (white arrow). A nodular aggregate of hyperplastic Leydig's cells is identified in lower half of image.

 

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