FDG PET/CT of Bilateral Testicular Lymphoma

Abstract

Testicular lymphoma is a rare extranodal presentation of nonHodgkin lymphoma. The most common type is diffuse large B-cell lymphoma. A 58-year-old man presented with painless enlargement of bilateral scrotums for about 6 months and a mass in the left neck for a month. The patient underwent an F-18 FDG PET/CT scan to evaluate the situation. The PET/CT scan demonstrated intense hypermetabolic activity in the bilateral enlarged testes, enlarged left adrenal gland, and multiple enlarged lymph nodes in the left neck, retroperitoneum, and bilateral inguinal region. Subsequent radical orchiectomy and pathologic examination revealed a large B-cell lymphoma infiltrating the testicular parenchyma.

Rare “Burned-Out” Testicular Mixed Germ Cell Tumor on 18F-FDG PET/CT

“…618 F-FDG PET/CT has been known with good ability to detect malignant germ cell tumors, 7 as well as many other malignant tumors and nonmalignant lesions. [8][9][10][11][12][13] In the current case, the incompatible characters of the metastases and testicular lesion on both PET and CT images are related to their different constituents, which is explainable by the rare burned-out phenomenon. More importantly, the testicular lesion may be missed if we overlook the CT component of PET/CT, which provides more diagnostic information than the PET component.…”

“…Embryonal carcinoma is the most common component and is often combined with 1 or more components of teratoma, seminoma, and yolk sac tumor 6 . 18 F-FDG PET/CT has been known with good ability to detect malignant germ cell tumors, 7 as well as many other malignant tumors and nonmalignant lesions 8–13 . In the current case, the incompatible characters of the metastases and testicular lesion on both PET and CT images are related to their different constituents, which is explainable by the rare burned-out phenomenon.…”

18F-FDG PET/CT in a Patient With Epididymo-Testicular Malacoplakia

“…1,2 Histologically, malakoplakia is characterized by present of von Hansemann cells and Michaelis-Gutmann bodies. 1,2 Because of its rarity and intense 18 F-FDG uptake, [3][4][5] diagnosing malakoplakia with PET/CT can be challenging, particularly when it occurs at atypical locations, as observed in this case. This case emphasizes that, in addition to some known benign (tuberculosis 6 and sarcoidosis 7 ) or malignant conditions (germ cell tumor, 8 stromal tumor, 9,10 metastasis, [11][12][13] and hematological malignancy involvement [14][15][16][17][18] ), the malakoplakia should be considered as a rare differential diagnosis for epididymo-testicular lesions with intense 18 F-FDG uptake on PET/CT, even in immunocompetent patients.…”