精巣微小石灰化症の14例

Abstract

陰嚢内容の異常を主訴とした男性患者において陰嚢部超音波検査を行った.精巣を10Mhzのリニア型のプローベを用いて観察し, 1画面に5個以上の石灰化を認めるものをclassic type(CTM), 5個未満をlimited type(LTM)と分類した.今迄に14例に精巣微小石灰化を認め, このうち6例がLTM, 8例がCTMであり, CTMの1例に精巣癌の合併を認めた.受診理由は急性精巣上体炎が最も多く, 精液瘤や静脈瘤等も認められたが, LTMとCTMとの間に明らかな差はなかった.検査所見では, 急性精巣上体炎と精管炎の5例がクラミジアが陽性であった.他に淋病とモルガン菌を1例づつ認めた.精液検査を2例で行い, うち1例で軽度の乏精子症を認めた.腫瘍マーカーを5例で検査したが, 全て正常範囲であった

Testicular microlithiasis (TM) is a comparatively rare condition in which calcified congelations fill the lumina of the seminiferous tubules. Using high-frequency linear transducers (10 MHz), TM is easily demonstrated as tiny punctate echogenic foci, which typically do not give an acoustic shadow, and is classified into classic type (CTM) and limited type (LTM) on the basis of the presence of five or more microliths at least on one image of the testes. Fourteen patients were found to have TM, 6 of which were LTM and 8 were CTM. In one patient with CTM, coexisting mixed germ cell tumor (seminoma, embryonal cell carcinoma) was demonstrated. Until further data are available, it seems reasonable to consider patients with TM as having an increased risk of developing a primary testicular tumor.