Presentation
Known diffuse large B-cell lymphoma with CNS involvement
Patient Data
The right testis demonstrates a few circumscribed hypoechoic masses, the largest one measuring up to 10 mm in diameter. Both testes have otherwise normal size, contours, and echogenicity. Small hydrocele 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 testis - 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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