Chronic lymphocytic leukemia and concurrent seminoma in the same testis

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Testicular germ cell tumors are common in young men.
• Seminoma is a specific type of germ cell tumor.
• Lymphoid neoplasms can occur in various body sites.

Purpose of the Study:

• To describe an exceptionally rare co-occurrence of testicular seminoma and chronic lymphocytic leukemia (CLL).
• To highlight the importance of considering this dual diagnosis in specific clinical scenarios.

Main Methods:

• Histopathological examination of a resected testicular mass.
• Immunohistochemical staining for lymphoid markers (CD20, CD79a, CD5, CD23, CD3, CD10, cyclin D1).
• Flow cytometry for kappa light chain restriction and circulating lymphoid cell count.

Main Results:

• The tumor exhibited a central seminoma component and a peripheral diffuse infiltration of CD20+, CD79a+, CD5+, CD23+ lymphoid cells.
• Flow cytometry confirmed kappa light chain restriction.
• Elevated circulating lymphoid cell count (>5.0×103/µL) supported the diagnosis of CLL infiltration.

Conclusions:

• The coexistence of seminoma and CLL infiltration in the testis is exceedingly rare.
• This case underscores the need for comprehensive differential diagnosis in testicular tumors, especially in older individuals.
• Recognition of this rare entity is vital for appropriate patient management.