Abstract
Primary testicular lymphoma (PTL) is a rare form of non-Hodgkin’s lymphoma more prevalent in males aged over 60 years old. PTL has a tendency to disseminate to systemic extranodal sites, however there has been a rare continuous spread involving the gonadal vein and spermatic cord. This method of dissemination has been described in 3 previous cases, and this case report presents another such case where such spread was noted, in a patient with a previous history of seminoma. Knowledge of this method of spread may increase the index of suspicion of PTL on cross-sectional imaging.
Highlights
Primary testicular lymphoma (PTL) is a rare form of non-Hodgkin’s lymphoma accounting for 5–9% of all testicular cancers.[1,2] It is most commonly diagnosed in males aged over 60, and the most common finding on histopathological analysis is a diffuse large B-cell non-Hodgkin’s lymphoma.[1,2] The method of spread of PTL has been suggested to be via both the haematogenous and lymphatic route,[3] with a tendency to disseminate to systemic extranodal sites, for instance the contralateral testis, central nervous system, lungs, pleura and soft tissue.[4]
There has been a rare phenomenon associated with PTL, whereby continuous spread along the spermatic cord and gonadal vein has been reported in three cases.[5,6]
With this rare method of spread of PTL in mind, we present a case of a patient with a background of previous testicular seminoma who was referred to our hospital with a left sided scrotal swelling; which was later found to be a PTL with spread up the left gonadal vessels
Summary
Primary testicular lymphoma (PTL) is a rare form of non-Hodgkin’s lymphoma accounting for 5–9% of all testicular cancers.[1,2] It is most commonly diagnosed in males aged over 60, and the most common finding on histopathological analysis is a diffuse large B-cell non-Hodgkin’s lymphoma.[1,2] The method of spread of PTL has been suggested to be via both the haematogenous and lymphatic route,[3] with a tendency to disseminate to systemic extranodal sites, for instance the contralateral testis, central nervous system, lungs, pleura and soft tissue.[4] There has been a rare phenomenon associated with PTL, whereby continuous spread along the spermatic cord and gonadal vein has been reported in three cases.[5,6] With this rare method of spread of PTL in mind, we present a case of a patient with a background of previous testicular seminoma who was referred to our hospital with a left sided scrotal swelling; which was later found to be a PTL with spread up the left gonadal vessels. This extended to the level of the left kidney, and a further large soft tissue suprarenal mass was noted [Figure 3]
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