Testicular
lymphoma was first reported by Malassez and Curling in 1866. Primary testicular
lymphoma constitutes only 1 - 7% of all
testicular neoplasms and less than 1% of all
non Hodgkin lymphoma. The authors report a new case of primary testicular
lymphoma and highlight its diagnostic and therapeutic challenge. We report the case of a 26-year old man without a particular past medical history, who presented with a painful right testicular swelling that he has noticed for several weeks. Radiological findings consisted in multiple hypoechoic masses that corresponded in histological examination to a diffuse intratubular lymphomatous infiltration situated away from the spermatic cord, the epididymis, ductuli efferentes and rete testis. Immunohistochemical study showed positivity for leukocytic common
antigen (CD45), B-cell marker (CD20) and bcl 6. The patient underwent full staging for
lymphoma showing no evidence of extra-testicular involvement by
lymphoma and no lymph nodes. The diagnosis of stage I primary testicular large
B-cell lymphoma of germinal center B-cell-like group was made. The patient is now treated by
chemotherapy. Primary testicular
lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non consensual etiological or predisposing factors. Treatment modalities consist in surgical excision,
chemotherapy and
radiation therapy but the accurate procedures are not standardized. Factors that have been linked to more favorable outcomes include younger patient age, localized disease, presence of
sclerosis at pathologic analysis, smaller tumour size, lower histological
tumor grade and lack of epididymal or spermatic cord involvement.
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