Abstract
Primary testicular lymphoma (PTL) accounts for ~1% of all non-Hodgkin’s lymphomas and has a marked tendency for systemic relapse. The current study presents a unique case of testicular diffuse large B-cell lymphoma of non-germinal center B-cell subtype, with subcutaneous masses as the sole manifestation of the first relapse and central nervous system lymphoma as the second relapse. Subcutaneous relapse and subsequent brain relapse are extremely rare signs of PTL dissemination. The patient received methotrexate-based combined chemotherapy and achieved a partial response. This case presents a rare pattern of treatment failure in this malignant clinical entity.
Highlights
Primary testicular lymphoma (PTL) is a rare disease accounting for ~1% of all non‐Hodgkin's lymphomas (NHLs) and 5% of all testicular malignant tumors [1,2,3,4]
The current study presents a rare case of PTL with subcutaneous masses as the sole manifestation of first relapse and central nervous system (CNS) lymphoma as the sole manifestation of second relapse
One retrospective study that was reported by the International Extranodal Lymphoma Study Group (IELSG) included 10 countries and 373 patients with primary testicular diffuse large B‐cell lymphoma (DLBCL) and found that the median age at diagnosis was 66 years
Summary
Primary testicular lymphoma (PTL) is a rare disease accounting for ~1% of all non‐Hodgkin's lymphomas (NHLs) and 5% of all testicular malignant tumors [1,2,3,4]. Physical examination of the patient revealed a right testicular mass and a system-by-system review of the body functions was unremarkable, including the absence of B symptoms. During the treatment and follow‐up, CT scans and ultrasound examinations showed no evidence of lymphoma progression. A biopsy was performed on the new lesions and the pathological observations revealed a DLBCL of non‐GCB subtype, with. The post‐treatment CT scan and ultrasound examination showed no additional evidence of lymphoma. A biopsy of this lesion was performed and the histopathological and immunohistochemical examinations revealed DLBCL of non‐GCB subtype. The patient was transferred to the Department of Hematology and the CT scans of the chest, abdomen and pelvis, and the ultrasound examination of the lymph nodes and left testicle were normal. The patient was closely followed for three months, but was lost to follow‐up
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