A 44-year-old man who consulted due to an increase in volume of the left testicle of 3 months of evolution, also presented cutaneous macular lesions in thigh and back of brownish color red, loss of 2 kg night fever, other
The right testicle was subsequently compromised.
She had a history of right saphenectomy due to vascular insufficiency and a father with hepatocarcinoma.
Physical examination revealed increased testicles in volume.
Ultrasonography showed enlarged testicles, right testicle of 5.4x3.8x3.9 cm, with presence of solid, hypoechoic, heterogeneous mass of 4 cm. with a low testicular parenchymal flow 3.8 cm.
Abdominal CT showed bilateral testicular masses, and multiple retroperitoneal lymph nodes and masses that could correspond to lymph node conglomerate in bilateral adrenal fossas.
BHCG was less than 5 UI/L, LDH was 1.29, AFP was 2.2, and ELISA for HIV was negative on two occasions.
Left upper orchidectomy, performed an enlarged testicle of 6x3.5x3.5 cm of par surface which in the section presented a poorly defined lesion occupying 3x2x2 pole
Histopathological examination showed extensive involvement by a hematolymphoid neoplasm composed of irregular pleomorphic nuclei with mitosis, angioinvasion and seminiferous tubule involvement.
The immunophenotypic study was positive for ACL, CD45KRO loss (IL-1), la CD3 and Bcl2, with weak expression of CD43, CD4 and CD4 and CD2, high proliferation index PL5 (ki67 expression ALcl56, CD30 EC10), and
This led to the diagnosis of non-Hodgkin lymphoma, peripheral T unspecified.
Extension studies in bone marrow and cerebrospinal fluid were negative.
The patient was managed with CHOP chemotherapy and intrathecal chemotherapy with MTX, dying after 6 months of follow-up.
1.
Literature search strategy
A structured literature search was conducted, based on the Cochrane methodology, in the databases Medline, Imbiomed and Scielo, from January 1950 to March 2009.
The keywords used were "Lymphoma", "Testis" and "T cell".
The search was limited to original articles written in English and Spanish, the methodology used is shown in Table 2.
Of the articles found, those considered relevant by the authors were selected for discussion of the subject.
