T-cell non-Hodgkin lymphoma of lymphoblastic type revealed by a chronic swollen testicle managed in the urology department of Laquintinie Hospital in Douala, Cameroon

Abstract

Background: Non-Hodgkin T-cell lymphomas typically develop in lymph node territories, and primary extra nodal locations are rare. The clinical presentation is nonspecific, dominated by signs of compression. Imaging aids in suspicion, and histology confirms the diagnosis. Clinical Observation: A 61-year-old patient initially hospitalized for the management of upper gastrointestinal bleeding six months ago was referred to the urology outpatient clinic due to a chronic swollen testicle persisting for a year. A non-contributory testicular ultrasound showed peri scrotal lymphedema with inguinal lymphadenopathy, right orchid epididymitis, and left epididymitis. Blood tests were normal. Despite antibiotic therapy, there was no improvement in the clinical condition. Physical examination revealed painless and mobile cervical, axillary, and inguinal lymph nodes. Pelvic MRI suspected a probable lymphoma. A lymph node biopsy in the left groin confirmed a non-Hodgkin T-cell lymphoma of lymphoblastic type infiltrating the capsule. The patient was transferred to haematology for further management. Conclusion: T-cell lymphoblastic lymphoma is primarily characterized by nodal involvement. There is a diagnostic delay that is anatomopathological in nature. Management involves polychemotherapy.