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Published on: March 30, 2018
[Primary Diffuse Large B-Cell Lymphoma of the Spermatic Cord : A Case Report]
Yuki Oda1, Masaya Hashimura1, Nobuo Ohyama1
1The Department of Urology, Nara Prefecture Seiwa Medical Center.
Insights
A rare case of primary diffuse large B-cell lymphoma (DLBCL) of the spermatic cord was diagnosed and treated. The patient received chemotherapy and planned radiation therapy, similar to testicular DLBCL treatment.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Primary spermatic cord tumors are rare, necessitating accurate diagnosis.
- Distinguishing between different lymphoma subtypes is crucial for appropriate treatment.
Observation:
- A 66-year-old man presented with a painless right inguinal mass.
- Initial diagnosis suggested spermatic cord tumor, later refined through immunostaining.
- Pathological examination revealed mucosa-associated lymphoid tissue (MALT) lymphoma, evolving to diffuse large B-cell lymphoma (DLBCL).
Findings:
- Final diagnosis: primary DLBCL Stage I of the spermatic cord.
- Positron emission tomography-computed tomography confirmed no residual tumor or metastasis.
- Treatment included R-THP-COP chemotherapy, Rituximab, intrathecal chemotherapy, and planned prophylactic radiation.
Implications:
- This case highlights the rarity of primary spermatic cord DLBCL.
- Standard treatment protocols for testicular DLBCL are applicable.
- Early and accurate diagnosis is key for effective management of spermatic cord lymphomas.
Abstract:
A 66-year-old man came to our department with the chief complaint of a right inguinal painless mass. He was diagnosed with a right spermatic cord tumor and underwent a right high orchiectomy with wide excision. The results of hematoxylin eosin staining and immunostaining procedures showed mucosa-associated lymphoid tissue (MALT) lymphoma originating from the lymphoid tissue of spermatic cord. The patient was referred to the department of hematology at another hospital for treatment. As results of additional immunostaining procedures at that hospital, the pathological diagnosis was diffuse large B-cell lymphoma (DLBCL). The positron emission tomography-computed tomography revealed no residual tumor or metastasis, and the final diagnosis was primary DLBCL Stage I of the spermatic cord. The patient was treated with 6 courses of R-THP-COP, 2 courses of Rituximab, and 3 courses of intrathecal chemotherapy, including Methotrexate, Ara-C, and Prednisolone. In addition, prophylactic radiation therapy to another testis was planned. Primary DLBCL of the spermatic cord is rare, and the standard treatment is the same as that for testicular DLBCL.
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