Testicular lymphoma - secondary involvement

Case contributed by Dr Bruno Di Muzio

Presentation

Known history of DLBCL with CNS involvement .

Patient Data

Age: 54 years
Gender: Male
Ultrasound

Testicular ultrasound

The right testicle demonstrates a few circumscribed hypoechoic masses, the largest one measuring up to 10 mm in diameter. Both testicles have otherwise normal size, contours, and echogenicity. Small hydrocoele on the right. The epididymis is normal bilaterally. Vascularity is preserved and within the normal limits. 

This patient had a lumbar puncture: 

Macroscopy: Cerebrospinal fluid - 0.5ml of clear, colourless fluid.

Microscopy: The preparation shows a mixed population of cells including red blood cells, monocytes, small lymphocytes, rare neutrophils and occasionally large, atypical lymphocytes with irregular nuclear contours, small nucleoli and blue cytoplasm. The features are suspicious for large cell lymphoma. Correlate with flow cytometry.

Opinion:  Cerebrospinal fluid: Suspicious for malignancy. 

Case Discussion

The lesions in the right testicle, in this case, most likely represent lymphoma in this clinical scenario. Diffuse large B-cell lymphoma (DLBCL) accounts for the majority (~80%) of testicular lymphoma cases. 

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Case information

rID: 59496
Published: 15th Apr 2018
Last edited: 16th Apr 2018
System: Urogenital
Inclusion in quiz mode: Excluded
Institution: Alfred Hospital

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