UWSA1 vs. FA discrepancy??

[skk3]

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hey! please help me understand something

UWSA1 describes a 26 year old man with a scrotal mass that is palpable when he stands but disappears when he lies down. (Naturally, by this point I was thinking varicocele, hernia, etc) But the next sentence was "the transillumination test is negative.

(By the way, the question was "what is the diagnosis" and the answer was varicocele)

I learned in class that one of the best ways to differentiate between testicular cancer and tunica vaginalis lesions was this transillumination test. This notion was confirmed by FA. 496.

Can anyone explain why a varicocele would not transilluminate? Is it maybe because the transillumination is not a sensitive test?

 

[ATrim7]

hey! please help me understand something

UWSA1 describes a 26 year old man with a scrotal mass that is palpable when he stands but disappears when he lies down. (Naturally, by this point I was thinking varicocele, hernia, etc) But the next sentence was "the transillumination test is negative.

(By the way, the question was "what is the diagnosis" and the answer was varicocele)

I learned in class that one of the best ways to differentiate between testicular cancer and tunica vaginalis lesions was this transillumination test. This notion was confirmed by FA. 496.

Can anyone explain why a varicocele would not transilluminate? Is it maybe because the transillumination is not a sensitive test?

This tripped me up for a moment too. First, the fact that the mass dissapears when he lies down should signal to you that it is a varicocele. The venous pressure is relieved when he lies down and the mass is not palpable.

Now, I also had the problem with the transillumination test being negative - but I think that UW is interpreting it as being "negative" for a solid mass (not negative in that is doesn't light up).