Abstract
Introduction. Testicular lymphoma is an aggressive disease with a very poor prognosis. Nasal-type natural killer/T-cell lymphoma (NKTCL-N) in particular is very uncommon and has a rapidly progressive, fatal course. Case Report. We report a case of primary NKTCL-N of the testis in a 38-years-old Middle Eastern man. The patient had a history of primary right testicular tumor diagnosed at an outside institution as a seminoma and treated with orchiectomy followed by chemo/radiation. On admission, the patient had an enormous nasal granuloma with blood workup showing pancytopenia and elevated liver function tests due to active hepatitis B infection. CT scan of the sinuses showed a very large soft tissue mass, and PET scan showed splenomegaly with multiple lymph node masses in the pelvis and the chest areas. Bone marrow and nasal tumor biopsies as well as review of the slides from the initial orchiectomy were all in favor of NKTCL-N lymphoma. The patient was treated with CHOD based combination chemotherapy and responded dramatically to the first two cycles but passed away from fulminant hepatitis B infection. Conclusion. Despite all known treatments of NKTCL-N lymphoma of the testes, this disease has a very poor prognosis and invariably follows an aggressive clinical course.
Highlights
Testicular lymphoma is an aggressive disease with a very poor prognosis
To date there are only 15 reported cases in the literature, and these mainly occurred in Asians and the Native American populations of Mexico and Central and South America [5,6,7,8,9,10,11,12,13,14,15,16,17,18]. In this case report we will report the 16th case of primary testicular NKTCL-N lymphoma and the first case to be reported in the Middle East
A 38-years-old Middle Eastern man was admitted to our hospital for the management of a nasal granuloma
Summary
According to the World Health Organization (WHO) classification of hematolymphoid tumors, there are three categories of natural killer cell tumors, extranodal NK/T-cell lymphoma, the nasal type (NKTCL-N), an aggressive NK cell leukemia, and blastic NK cell lymphoma. The Nasal variant occurs mainly in midline structures including the nasal cavity, nasopharynx, and paranasal sinuses, whereas the extranasal one involves the skin, the gastrointestinal tract, the salivary glands, the spleen, the lungs, and the testis [1] Regardless of these presentations, the WHO classification groups both nasal and extranasal NKTCL-N lymphoma in the same category as “nasal type” they have different clinical manifestations, treatment approaches, and prognosis [2, 3]. To date there are only 15 reported cases in the literature, and these mainly occurred in Asians and the Native American populations of Mexico and Central and South America [5,6,7,8,9,10,11,12,13,14,15,16,17,18] In this case report we will report the 16th case of primary testicular NKTCL-N lymphoma and the first case to be reported in the Middle East
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