Primary testicular diffuse large B-cell lymphoma: A case report

Abstract

Primary testicular diffuse large-B cell lymphoma (DLBCL) is an uncommon and aggressive disease with predominant manifestation in the older age. Herein, we report a case of 47-year-old male patient who presented with three months history of left testis swelling. The patient underwent unilateral (left) radical orchiectomy. Histopathological examination revealed extensive involvement and replacement of testicular parenchyma by a tumor composed of large discohesive sheets of cells with pleomorphic, hyperchromatic nuclei and prominent nucleoli. Immunohistochemical (IHC) staining showed reactivity for LCA & Pan B (CD20) and negativity for OCT 3/4, SALL4 and Inhibin. Moreover, Pan T (CD3) highlighted reactive T-cells. These features rendered the diagnosis of DLBCL of testis. The hybrid 2-[fluorine-18] fluoro-2deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated two para-aortic FDG avid lymph nodes on the left side at the level of L2 vertebra. Presently, the patient has been planned for doxorubicin-based chemotherapy (i.e., cyclophosphamide, doxorubicin, vincristine and prednisone; CHOP) along with intrathecal Methroxate (MTX), which would presumably improve the prognosis. Our study would expand the pool of this uncommon tumor towards its better understanding.

Abnormal presentation of a bilateral, synchronous and plurimetastatic medium and large cell testicular lymphoma: A case report

“…Although the approval of rituximab for PTL has been saluted as a potential favourable therapeutic addition, the impact on the outcomes remains unclear (13). Few other similar and recent cases are reported in the literature: Yan et al (14) reported the case of a 63-year-old patient with a CNS relapse after a successful treatment of an early monolateral PTL; Sia et al (15) reported the case of a younger patient (56-year old) with a right testicular PTL who underwent to scrotal radiotherapy after the R-CHOP protocol and intrathecal methotrexate; Sadiq et al (16) reported the case of a 47-year old patients with left PTL; finally Batista and Safriadi (17) reported the case of a bilateral PTL in a 48-year old male, which was treated similarly to our case. Albeit a relatively low testosterone level is reported, PTL is not associated with hypotestosteronaemia, albeit the subsequent treatment could impair the (residual) testicular function.…”