Rare, rapid and resolved: a case of primary aggressive testicular non-Hodgkin’s lymphoma
DOI:
https://doi.org/10.18203/2349-2902.isj20261192Keywords:
Primary testicular lymphoma, Non-Hodkin’s lymphoma, Diffuse large B-cell lymphoma, CNS prophylaxis, Multimodal treatmentAbstract
Primary testicular lymphoma (PTL) is a rare and aggressive extra nodal manifestation of non-Hodgkin’s lymphoma (NHL), accounting for 1-2% of all NHL cases and 5% of testicular tumors. We report a case of a 62-year-old male presenting with a rapidly enlarging painless right testicular mass and right inguinal lymphadenopathy. Imaging and PET-CT revealed a metabolically active testicular mass with regional lymph node involvement. He underwent right high inguinal orchidectomy with inguinal lymph node excision. Histopathology and immunohistochemistry confirmed diffuse large B-cell lymphoma (DLBCL), non-germinal center type, double expressor phenotype. The patient received systemic R-CHOP chemotherapy with CNS prophylaxis and adjuvant radiotherapy. Follow-up PET-CT at 1 year showed complete remission. This case highlights the importance of a multimodal approach including surgery, immunochemotherapy, CNS prophylaxis, and scrotal irradiation for optimal disease control in PTL.
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Ailani S, Raghava M, Sethi N, Vijaywargiya M. Adult Testicular Non-Hodgkin’s Lymphoma: A Rare Case Series. J Med Sci. 2024;10(2):213. DOI: https://doi.org/10.46347/jmsh.v10.i2.23.17
Staouni BY, Sidki S, Kbirou A, Moataz A, Dakir M, Debbagh A and Aboutaieb R. Non-Hodgkin's Lymphoma of the Testis. IJCMCR. 2024;41(5):005.
Anantharamakrishnan R, Kumar S, Pranay K, Rao RS. Primary Testicular Lymphoma a Rare Extra Nodal Involvement of NHL. J Pharm Res Int. 2021;33(55B):161-4. DOI: https://doi.org/10.9734/jpri/2021/v33i55B33860
Roy S, Soni TP, Sharma U, Sharma A. Primary testicular lymphoma: A case report. J Cancer Res Ther. 2025;21(1):186-8. DOI: https://doi.org/10.4103/jcrt.jcrt_1482_22
Vollmer RT, Johnson DE, Bodey GP. Primary non-Hodgkin’s lymphoma of the testis: a clinicopathologic study of 38 cases. Am J Surg Pathol. 1985;9(8):555-64.
Greb A, Klapper W, Hoster E. Immunophenotypic subtypes of diffuse large B-cell lymphoma: prognostic significance and gene expression profiles. Blood. 2012;119(11):2606-16.
Cheah CY, Wirth A, Seymour JF. Primary testicular lymphoma: management and outcome of 373 patients. Blood. 2014;124(9):1434-41.
Zucca E, Conconi A, Laszlo D, Sarris AH, Seymour JF, Vitolo U, et al. Patterns of outcome and prognostic factors in primary extranodal non-Hodgkin’s lymphomas: analysis of 1,066 patients. J Clin Oncol. 2003;21(1):20-8. DOI: https://doi.org/10.1200/JCO.2003.11.141
Cheah CY, Ardeshna KM, Seymour JF. Long-term outcomes of R-CHOP in primary testicular DLBCL: an international multicenter study. Leuk Lymphoma. 2018;59(8):1988-96.
Vitolo U, Chiappella A, Giordano L, Maurizio M, Ileana B, Monica B, et al. Rituximab plus CHOP and prophylaxis for CNS involvement in primary testicular diffuse large B-cell lymphoma: results of a prospective multicenter phase II trial. J Clin Oncol. 2011;2(20):2766-72. DOI: https://doi.org/10.1200/JCO.2010.31.4187
Ren H, Liu Q, Zhai L. Clinical characteristics and outcomes of primary testicular lymphoma: a single-centre retrospective study. Oncol Lett. 2012;3(4):627-31.
Twa DDW, Pittaluga S, Feldman AL. Genomic landscape of primary testicular lymphoma reveals underlying mechanisms of immune escape and sanctuary-site relapse. Blood. 2021;137(10):1326-36.
Rubenstein JL, Fridlyand J, Shen A, Ken A, David G, Tracy B, et al. Gene expression and angiotropism in primary testicular diffuse large B-cell lymphoma: implications for targeted therapy. Clin Cancer Res. 2015;21(3):621-8.
Grommes C, Pastore A, Palaskas N. Ibrutinib unmasks critical role of Bruton tyrosine kinase in primary CNS lymphoma. Cancer Discov. 2017;7(9):1018-29. DOI: https://doi.org/10.1158/2159-8290.CD-17-0613
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