On ultrasound of the scrotum, a testicular mass shows a hypoechoic area with peripheral calcifications and a 'snowstorm' appearance of fine internal calcifications scattered throughout both testes. This bilateral calcification pattern is termed:

• A Orchitis with microlithiasis
• B Calcifying Sertoli cell tumour
• C Testicular microlithiasis (TML) — bilateral ✓
• D Schistosomiasis of the testis

Explanation

Testicular microlithiasis (TML) is defined on ultrasound as ≥5 calcific foci per transducer field in one or both testes, producing the 'snowstorm' pattern of fine hyperechoic foci without posterior shadowing. Bilateral TML is associated with an increased risk of testicular germ cell tumours and requires annual ultrasound surveillance. It should not be dismissed as benign without follow-up. Orchitis typically shows hypervascularity and hypoechogenicity.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.