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Current status of percutaneous testicular biopsy for focal lesions

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Abstract

Objective

The purpose of this review is to evaluate the current role of percutaneous testicular biopsy in the diagnosis of focal testicular lesions.

Conclusion

Percutaneous testicular biopsy can be either fine needle aspiration biopsy or trucut core needle biopsy. It is a well-tolerated and effective procedure useful in small testicular lesions, multifocal lesions, hematological malignancies, and focal lesions in single testis.

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References

  1. Purdue MP, Devesa SS, Sigurdson AJ, McGlynn KA (2005) International patterns and trends in testis cancer incidence. Int J Cancer 115(5):822–827. https://doi.org/10.1002/ijc.20931

    Article  CAS  PubMed  Google Scholar 

  2. Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Van Hemelrijck M (2013) Global incidence and outcome of testicular cancer. Clin Epidemiol 5:417–427. https://doi.org/10.2147/clep.s34430

    Article  PubMed  PubMed Central  Google Scholar 

  3. Siegel RL, Miller KD (2015) Jemal A (2015) Cancer statistics. CA Cancer J Clin 65(1):5–29. https://doi.org/10.3322/caac.21254

    Article  PubMed  Google Scholar 

  4. Coursey Moreno C, Small WC, Camacho JC, et al. (2015) Testicular tumors: what radiologists need to know–differential diagnosis, staging, and management. Radiographics 35(2):400–415. https://doi.org/10.1148/rg.352140097

    Article  PubMed  Google Scholar 

  5. Dogra VS, Gottlieb RH, Oka M, Rubens DJ (2003) Sonography of the scrotum. Radiology 227(1):18–36. https://doi.org/10.1148/radiol.2271001744

    Article  PubMed  Google Scholar 

  6. Carmignani L, Gadda F, Gazzano G, et al. (2003) High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol 170(5):1783–1786. https://doi.org/10.1097/01.ju.0000092066.01699.90

    Article  PubMed  Google Scholar 

  7. Brunocilla E, Gentile G, Schiavina R, et al. (2013) Testis-sparing surgery for the conservative management of small testicular masses: an update. Anticancer Res 33(11):5205–5210

    PubMed  Google Scholar 

  8. Eifler JB Jr, King P, Schlegel PN (2008) Incidental testicular lesions found during infertility evaluation are usually benign and may be managed conservatively. J Urol 180(1):261–264 (discussion 265). https://doi.org/10.1016/j.juro.2008.03.021

    Article  PubMed  Google Scholar 

  9. Rocher L, Ramchandani P, Belfield J, et al. (2016) Incidentally detected non-palpable testicular tumours in adults at scrotal ultrasound: impact of radiological findings on management Radiologic review and recommendations of the ESUR scrotal imaging subcommittee. Eur Radiol 26(7):2268–2278. https://doi.org/10.1007/s00330-015-4059-7

    Article  PubMed  Google Scholar 

  10. Dieckmann KP, Frey U, Lock G (2013) Contemporary diagnostic work-up of testicular germ cell tumours. Nat Rev Urol 10(12):703–712. https://doi.org/10.1038/nrurol.2013.254

    Article  PubMed  Google Scholar 

  11. Giannarini G, Dieckmann KP, Albers P, Heidenreich A, Pizzocaro G (2010) Organ-sparing surgery for adult testicular tumours: a systematic review of the literature. Eur Urol 57(5):780–790. https://doi.org/10.1016/j.eururo.2010.01.014

    Article  PubMed  Google Scholar 

  12. Albers P, Albrecht W, Algaba F, et al. (2015) Guidelines on Testicular Cancer: 2015 Update. Eur Urol 68(6):1054–1068. https://doi.org/10.1016/j.eururo.2015.07.044

    Article  PubMed  Google Scholar 

  13. Aganovic L, Cassidy F (2012) Imaging of the scrotum. Radiol Clin North Am 50(6):1145–1165. https://doi.org/10.1016/j.rcl.2012.08.003

    Article  PubMed  Google Scholar 

  14. Carkaci S, Ozkan E, Lane D, Yang WT (2010) Scrotal sonography revisited. J Clin Ultrasound 38(1):21–37. https://doi.org/10.1002/jcu.20642

    Article  PubMed  Google Scholar 

  15. Huang DY, Sidhu PS (2012) Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Br J Radiol 85(1):S41–S53. https://doi.org/10.1259/bjr/30029741

    Article  PubMed  PubMed Central  Google Scholar 

  16. Auer T, De Zordo T, Dejaco C, et al. (2017) Value of multiparametric US in the assessment of intratesticular lesions. Radiology 285(2):640–649. https://doi.org/10.1148/radiol.2017161373

    Article  PubMed  Google Scholar 

  17. Valentino M, Bertolotto M, Derchi L, et al. (2011) Role of contrast enhanced ultrasound in acute scrotal diseases. Eur Radiol 21(9):1831–1840. https://doi.org/10.1007/s00330-010-2039-5

    Article  PubMed  Google Scholar 

  18. Aigner F, De Zordo T, Pallwein-Prettner L, et al. (2012) Real-time sonoelastography for the evaluation of testicular lesions. Radiology 263(2):584–589. https://doi.org/10.1148/radiol.12111732

    Article  PubMed  Google Scholar 

  19. Goddi A, Sacchi A, Magistretti G, Almolla J, Salvadore M (2012) Real-time tissue elastography for testicular lesion assessment. Eur Radiol 22(4):721–730. https://doi.org/10.1007/s00330-011-2312-2

    Article  PubMed  Google Scholar 

  20. Patel K, Sellars ME, Clarke JL, Sidhu PS (2012) Features of testicular epidermoid cysts on contrast-enhanced sonography and real-time tissue elastography. J Ultrasound Med 31(1):115–122

    Article  PubMed  Google Scholar 

  21. Tsili AC, Argyropoulou MI, Giannakis D, Sofikitis N, Tsampoulas K (2010) MRI in the characterization and local staging of testicular neoplasms. AJR Am J Roentgenol 194(3):682–689. https://doi.org/10.2214/ajr.09.3256

    Article  PubMed  Google Scholar 

  22. Tsili AC, Bertolotto M, Turgut AT, et al. (2018) MRI of the scrotum: recommendations of the ESUR Scrotal and Penile Imaging Working Group. Eur Radiol 28(1):31–43. https://doi.org/10.1007/s00330-017-4944-3

    Article  PubMed  Google Scholar 

  23. Rifkin MD, Kurtz AB, Pasto ME, Goldberg BB (1985) Diagnostic capabilities of high-resolution scrotal ultrasonography: prospective evaluation. J Ultrasound Med 4(1):13–19

    Article  CAS  PubMed  Google Scholar 

  24. van Dijk R, Doesburg WH, Verbeek AL, et al. (1994) Ultrasonography versus clinical examination in evaluation of testicular tumors. J Clin Ultrasound 22(3):179–182

    Article  PubMed  Google Scholar 

  25. Muller T, Gozzi C, Akkad T, et al. (2006) Management of incidental impalpable intratesticular masses of < or = 5 mm in diameter. BJU Int 98(5):1001–1004. https://doi.org/10.1111/j.1464-410X.2006.06485.x

    Article  PubMed  Google Scholar 

  26. Dohle GR, Elzanaty S, van Casteren NJ (2012) Testicular biopsy: clinical practice and interpretation. Asian J Androl 14(1):88–93. https://doi.org/10.1038/aja.2011.57

    Article  PubMed  Google Scholar 

  27. Mahajan AD, Ali NI, Walwalkar SJ, Rege JD, Pathak HR (1999) The role of fine-needle aspiration cytology of the testis in the diagnostic evaluation of infertility. BJU Int 84(4):485–488

    Article  CAS  PubMed  Google Scholar 

  28. Carpi A, Menchini Fabris FG, Palego P, et al. (2005) Fine-needle and large-needle percutaneous aspiration biopsy of testicles in men with nonobstructive azoospermia: safety and diagnostic performance. Fertil Steril 83(4):1029–1033. https://doi.org/10.1016/j.fertnstert.2004.09.027

    Article  PubMed  Google Scholar 

  29. Herts BR, Baker ME (1995) The current role of percutaneous biopsy in the evaluation of renal masses. Semin Urol Oncol 13(4):254–261

    CAS  PubMed  Google Scholar 

  30. Blumenfeld AJ, Guru K, Fuchs GJ, Kim HL (2010) Percutaneous biopsy of renal cell carcinoma underestimates nuclear grade. Urology 76(3):610–613. https://doi.org/10.1016/j.urology.2009.09.095

    Article  PubMed  Google Scholar 

  31. Leveridge MJ, Finelli A, Kachura JR, et al. (2011) Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy. Eur Urol 60(3):578–584. https://doi.org/10.1016/j.eururo.2011.06.021

    Article  PubMed  Google Scholar 

  32. Volpe A, Mattar K, Finelli A, et al. (2008) Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J Urol 180(6):2333–2337. https://doi.org/10.1016/j.juro.2008.08.014

    Article  PubMed  Google Scholar 

  33. Leibovitch I, Baniel J, Foster RS, Donohue JP (1995) The clinical implications of procedural deviations during orchiectomy for nonseminomatous testis cancer. J Urol 154(3):935–939

    Article  CAS  PubMed  Google Scholar 

  34. Capelouto CC, Clark PE, Ransil BJ, Loughlin KR (1995) A review of scrotal violation in testicular cancer: is adjuvant local therapy necessary? J Urol 153(3 Pt 2):981–985

    CAS  PubMed  Google Scholar 

  35. Aki FT, Bilen CY, Tekin MI, Ozen H (2000) Is scrotal violation per se a risk factor for local relapse and metastases in stage I nonseminomatous testicular cancer? Urology 56(3):459–462

    Article  CAS  PubMed  Google Scholar 

  36. Giguere JK, Stablein DM, Spaulding JT, et al. (1988) The clinical significance of unconventional orchiectomy approaches in testicular cancer: a report from the Testicular Cancer Intergroup Study. J Urol 139(6):1225–1228

    Article  CAS  PubMed  Google Scholar 

  37. Browne RF, Jeffers M, McDermott T, et al. (2003) Technical report. Intra-operative ultrasound-guided needle localization for impalpable testicular lesions. Clin Radiol 58(7):566–569

    Article  CAS  PubMed  Google Scholar 

  38. Chan PT, Schlegel PN (2000) Diagnostic and therapeutic testis biopsy. Curr Urol Rep 1(4):266–272

    Article  CAS  PubMed  Google Scholar 

  39. Hopps CV, Goldstein M (2002) Ultrasound guided needle localization and microsurgical exploration for incidental nonpalpable testicular tumors. J Urol 168(3):1084–1087. https://doi.org/10.1097/01.ju.0000025141.88860.0d

    Article  PubMed  Google Scholar 

  40. Kirkham AP, Kumar P, Minhas S, et al. (2009) Targeted testicular excision biopsy: when and how should we try to avoid radical orchidectomy? Clin Radiol 64(12):1158–1165. https://doi.org/10.1016/j.crad.2009.06.008

    Article  CAS  PubMed  Google Scholar 

  41. Akhtar M, Al Dayel f (1997) Is it feasible to diagnose germ-cell tumors by fine-needle aspiration biopsy? Diagn Cytopathol 16(1):72–77

    Article  CAS  PubMed  Google Scholar 

  42. Garcia-Solano J, Sanchez-Sanchez C, Montalban-Romero S, Sola-Perez J, Perez-Guillermo M (1998) Fine needle aspiration (FNA) of testicular germ cell tumours; a 10-year experience in a community hospital. Cytopathology 9(4):248–262

    Article  CAS  PubMed  Google Scholar 

  43. Verma K, Ram TR, Kapila K (1989) Value of fine needle aspiration cytology in the diagnosis of testicular neoplasms. Acta Cytol 33(5):631–634

    CAS  PubMed  Google Scholar 

  44. Lorenzo Gomez MF (2000) Usefulness of fine needle aspiration puncture in the diagnosis of testicular neoplasms and in the study of testicular physiopathology. Arch Esp Urol 53(6):433–442

    CAS  PubMed  Google Scholar 

  45. Singh AD, Wani FA, Bhardwaj S (2017) Diagnostic accuracy of FNAC and cyto-histopathological correlation in testicular and paratesticular mass lesions. Cytopathology 28(6):542–548. https://doi.org/10.1111/cyt.12456

    Article  CAS  PubMed  Google Scholar 

  46. Meng MV, Cha I, Ljung BM, Turek PJ (2001) Testicular fine-needle aspiration in infertile men: correlation of cytologic pattern with biopsy histology. Am J Surg Pathol 25(1):71–79

    Article  CAS  PubMed  Google Scholar 

  47. Aridogan IA, Bayazit Y, Yaman M, Ersoz C, Doran S (2003) Comparison of fine-needle aspiration and open biopsy of testis in sperm retrieval and histopathologic diagnosis. Andrologia 35(2):121–125

    Article  CAS  PubMed  Google Scholar 

  48. Shaida N, Berman LH (2012) Percutaneous testicular biopsy for indeterminate testicular lesions. Br J Radiol 85(1):S54–S58. https://doi.org/10.1259/bjr/30496032

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kulkarni KP, Marwaha RK, Trehan A, Bansal D (2010) Testicular relapse in childhood acute lymphoblastic leukemia: the challenges and lessons. Indian J Cancer 47(2):134–138. https://doi.org/10.4103/0019-509x.63002

    Article  CAS  PubMed  Google Scholar 

  50. Shama G, Bhagwat R, Pai SK, et al. (2005) Isolated testicular relapse in acute lymphoblastic leukemia-effective treatment with the modified CCG-112 protocol. Indian J Cancer 42(2):65–69

    Article  PubMed  Google Scholar 

  51. National Comprehensive Cancer Network. Testicular cancer (Version 2.2018). https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf. Accessed 27 Feb 2018

  52. Locatelli F, Schrappe M, Bernardo ME, Rutella S (2012) How I treat relapsed childhood acute lymphoblastic leukemia. Blood 120(14):2807–2816. https://doi.org/10.1182/blood-2012-02-265884

    Article  CAS  PubMed  Google Scholar 

  53. de Almeida MM, Chagas M, de Sousa JV, Mendonca ME (1994) Fine-needle aspiration cytology as a tool for the early detection of testicular relapse of acute lymphoblastic leukemia in children. Diagn Cytopathol 10(1):44–46

    Article  PubMed  Google Scholar 

  54. Kumar PV (1998) Testicular leukemia relapse. Fine needle aspiration findings. Acta Cytol 42(2):312–316

    Article  CAS  PubMed  Google Scholar 

  55. Dieckmann KP, Kulejewski M, Pichlmeier U, Loy V (2007) Diagnosis of contralateral testicular intraepithelial neoplasia (TIN) in patients with testicular germ cell cancer: systematic two-site biopsies are more sensitive than a single random biopsy. Eur Urol 51(1):175–183 (discussion 183-175). https://doi.org/10.1016/j.eururo.2006.05.051

    Article  PubMed  Google Scholar 

  56. Soh E, Berman LH, Grant JW, Bullock N, Williams MV (2008) Ultrasound-guided core-needle biopsy of the testis for focal indeterminate intratesticular lesions. Eur Radiol 18(12):2990–2996. https://doi.org/10.1007/s00330-008-1072-0

    Article  PubMed  Google Scholar 

  57. Ratkal V, Chawla A, Mishra DK, Monappa V (2015) Testicular non-Hodgkin’s lymphoma presenting in a young adult. BMJ Case Rep . https://doi.org/10.1136/bcr-2014-208633

    Article  PubMed  PubMed Central  Google Scholar 

  58. Subik MK, Gordetsky J, Yao JL, di Sant’Agnese PA, Miyamoto H (2012) Frozen section assessment in testicular and paratesticular lesions suspicious for malignancy: its role in preventing unnecessary orchiectomy. Hum Pathol 43(9):1514–1519. https://doi.org/10.1016/j.humpath.2011.11.013

    Article  PubMed  Google Scholar 

  59. Ulbright TM, Young RH (2008) Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. Am J Surg Pathol 32(11):1683–1693. https://doi.org/10.1097/PAS.0b013e3181788516

    Article  PubMed  Google Scholar 

  60. Verma N, Lazarchick J, Gudena V, Turner J, Chaudhary UB (2008) Testicular lymphoma: an update for clinicians. Am J Med Sci 336(4):336–341. https://doi.org/10.1097/MAJ.0b013e31817242bc

    Article  PubMed  Google Scholar 

  61. Harris RD, Chouteau C, Partrick M, Schned A (2000) Prevalence and significance of heterogeneous testes revealed on sonography: ex vivo sonographic-pathologic correlation. AJR Am J Roentgenol 175(2):347–352. https://doi.org/10.2214/ajr.175.2.1750347

    Article  CAS  PubMed  Google Scholar 

  62. Stewart VR, Sidhu PS (2007) The testis: the unusual, the rare and the bizarre. Clin Radiol 62(4):289–302. https://doi.org/10.1016/j.crad.2006.10.005

    Article  CAS  PubMed  Google Scholar 

  63. Bhatt S, Jafri SZ, Wasserman N, Dogra VS (2011) Imaging of non-neoplastic intratesticular masses. Diagn Interv Radiol 17(1):52–63. https://doi.org/10.4261/1305-3825.dir.3116-09.0

    Article  PubMed  Google Scholar 

  64. Mihmanli I, Kantarci F (2009) Sonography of scrotal abnormalities in adults: an update. Diagn Interv Radiol 15(1):64–73

    PubMed  Google Scholar 

  65. Qublan HS, Al-Jader KM, Al-Kaisi NS, et al. (2002) Fine needle aspiration cytology compared with open biopsy histology for the diagnosis of azoospermia. J Obstet Gynaecol 22(5):527–531. https://doi.org/10.1080/0144361021000003690

    Article  CAS  PubMed  Google Scholar 

  66. Pandey A, Nandini N, Jha A, Manjunath G (2011) Fine needle aspiration cytology and cell block in the diagnosis of seminoma testis. J Cytol 28(1):39–41. https://doi.org/10.4103/0970-9371.76950

    Article  PubMed  PubMed Central  Google Scholar 

  67. Rammou-Kinia R, Anagnostopoulou I, Tassiopoulos F, Lykourinas M (1999) Fine needle aspiration of the testis. Correlation between cytology and histology. Acta Cytol 43(6):991–998

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Al-Wakra Hospital, Hamad Medical Corporation, PO Box 82228, Doha, Qatar

    Subramaniyan Ramanathan

  2. Department of Radiology, Weil Cornell Medical College, Doha, Qatar

    Subramaniyan Ramanathan

  3. Department of Imaging Science, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Vikram Dogra

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Correspondence to Subramaniyan Ramanathan.

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Ramanathan, S., Dogra, V. Current status of percutaneous testicular biopsy for focal lesions. Abdom Radiol 43, 3125–3131 (2018). https://doi.org/10.1007/s00261-018-1560-x

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