Seminoma CT: Difference between revisions

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==Overview==
==Overview==
Abdominal and pelvic CT scans may be diagnostic of seminoma.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref> CT may detect metastases of seminoma to the para-aortic, inguinal, or iliac lymph nodes. Visceral metastasis may also be seen.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref>
[[Abdominal]] and [[Pelvis|pelvic]] [[Computed tomography|CT scans]] may be [[diagnostic]] of seminoma. [[CT scan]] may detect [[metastases]] of seminoma to the para-aortic, [[inguinal]] or [[iliac]] [[Lymph node|lymph nodes]]. [[Visceral]] [[Metastasis|metastas]] is may observed.[[Chest]] [[CT]] is indicated when [[Chest X-ray|CXR]] is [[abnormal]] regional para-[[aortic]] [[lymph node]] spread is present.


==CT==
==CT==
*Abdominal and pelvic CT scans are important in visualizing metastases both as a part of primary staging of seminoma and in primary diagnosis when a testicular mass is unknown.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref>
* [[Abdominal]] and [[pelvic]] [[Computed tomography|CT scan]] may be helpful in the [[diagnosis]] of seminoma. Findings on [[Computed tomography|CT scan]] [[diagnostic]] of seminoma include:<ref name="radiographicfeaturesofptesticularseminoma1">Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref><ref name="pmid28574809">{{cite journal |vauthors=Marko J, Wolfman DJ, Aubin AL, Sesterhenn IA |title=Testicular Seminoma and Its Mimics: From the Radiologic Pathology Archives |journal=Radiographics |volume=37 |issue=4 |pages=1085–1098 |date=2017 |pmid=28574809 |pmc=5548453 |doi=10.1148/rg.2017160164 |url=}}</ref>
*[[Metastases]] to the para-aortic lymph nodes at the level of the renal vessels are the typical first site of spread owing to the lymphatic drainage of the testicles relating to embryological testicular descent. The nodal metastases are often bulky, of homogenous density, and tend to encase surrounding vessels.
** [[Retroperitoneal]] [[Lymph node|lymph nodes]]
*Inguinal or iliac lymph node metastases suggest lymphatic spread via the scrotum and therefore local tumor extension beyond the [[tunica vaginalis]].
** [[Metastases]] to the para-[[aortic]] [[lymph nodes]] (It is the first site of spread [[lymphatic]] drainage at the level of the [[renal]] [[vessels]])
*Visceral (distant) [[metastases]] are seen in around 5% of patients at presentation (lung, liver, bone, brain). Staging CT of the chest is only indicated when regional para-aortic lymph node spread is present or if there is an abnormal CXR.
*** Bulky nodal
*Following therapy, lymph node metastases reduce markedly in size but some inactive abnormal tissue persists which can be difficult to distinguish from residual disease and follow up monitoring is required.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref>
*** [[Density]] [[homogenous]],
*** Tend to encase surrounding [[vessels]]
** [[Inguinal]] or [[iliac]] [[lymph node]] [[Metastasis|metastases]] suggest:
*** [[lymphatic]] spread by the [[scrotum]]
***local [[tumor]] [[extension]] further the [[tunica vaginalis]]
***
**
**[[Visceral]] [[metastases]]
** [[Chest]] [[CT]] is indicated when:
*** [[Chest X-ray|CXR]] is [[abnormal]]
*** Regional para-[[aortic]] [[lymph node]] spread is present
[[File:Seminoma_in_CT_(2).jpg|500px|none|thumb|https://en.wikipedia.org/wiki/Seminoma#/media/File:Seminoma_in_CT_(2).jpg]]


==References==
==References==
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Latest revision as of 16:13, 2 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Abdominal and pelvic CT scans may be diagnostic of seminoma. CT scan may detect metastases of seminoma to the para-aortic, inguinal or iliac lymph nodes. Visceral metastas is may observed.Chest CT is indicated when CXR is abnormal regional para-aortic lymph node spread is present.

CT

https://en.wikipedia.org/wiki/Seminoma#/media/File:Seminoma_in_CT_(2).jpg

References

  1. Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016
  2. Marko J, Wolfman DJ, Aubin AL, Sesterhenn IA (2017). "Testicular Seminoma and Its Mimics: From the Radiologic Pathology Archives". Radiographics. 37 (4): 1085–1098. doi:10.1148/rg.2017160164. PMC 5548453. PMID 28574809.

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