睪丸自然殺手/T細胞淋巴瘤之病例報告 

謝棨圳¹、錢祖明¹

¹高雄醫學大學附設中和紀念醫院泌尿部

Testicular NK/T cell lymphoma: A Case Report

Chi-Chun Hsieh¹, Tsu-Ming Chien¹

¹Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Abstract:

Background: Primary testicular non-Hodgkin lymphoma is rare, accounting less than 2% of lymphoma. Mostly, histological type of testicular lymphoma is diffuse large B-cell lymphoma. Primary NK/T cell lymphoma is even more scarce and more aggressive. We report a case of primary testicular NK/T cell lymphoma.

Cases Presentation: A 57-year-old male with history of left nasal tumor with non-Langerhans cell histiocytosis post three courses of chemotherapy with Cytarabine. He complained bilateral scrotal swelling and tenderness for one month with skin redness. Lab data survey revealed normal alpha-fetoprotein and beta-hCG and slightly increased lactate dehydrogenase (393 IU/L). MRI (magnetic resonance imaging) showed necrosis in the bilateral testes and epididymides. We performed right radical orchiectomy and left hydrocelectomy for him. Microscopically, immunohistochemial stain, the tumor cells are positive for CD3, CD56, granzyme B. Epstein–Barr virus-encoding RNA (EBER) in situ hybridization is positive. The finding suggests extranodal NK/T cell lymphoma.

We then arrange positron emission tomography (PET) scan and result showed compatible with lymphoma as fluorodeoxyglucose (FDG)-avid lesions over head, external genital organ, bone marrow, bilateral external iliac and inguinal lymph nodes. On three months of diagnosis, however, the patient passed away after two courses of adjuvant chemotherapy.

Conclusion: In conclusion, primary NT/T cell lymphoma of testis is extremely with highly aggressive features. Previous known reports showed early recurrence and poor response to current treatment regimen.