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Updated: Sep 4, 2026
Intravital Microscopy of the Inguinal Lymph Node
Published on: April 4, 2011
Diffuse large B-cell lymphoma presenting as an inguinal hernia - case report
Sam Kinet1, Eddy F P Kuppens2, Hendrik Maes2
1KU Leuven, AZ Alma (General Hospital), Eeklo, Belgium.
Insights
A rare case of diffuse large B-cell lymphoma (DLBCL) presented as an inguinal hernia. Diagnosis required surgical exploration, revealing a paratesticular tumor treated successfully with chemotherapy.
Area of Science:
- Oncology
- Surgical Pathology
- Genitourinary Oncology
Background:
- Diffuse large B-cell lymphoma (DLBCL) rarely mimics inguinal hernias.
- A 73-year-old male with a history of bilateral inguinal hernia repair presented with a recurrent groin bulge.
Observation:
- Sonography suggested recurrent inguinal hernia, but intraoperative findings revealed a lump attached to the spermatic cord without a hernial sac.
- A possible malignant etiology was suspected, leading to orchiectomy and lump resection.
Findings:
- Histopathology confirmed DLBCL with a non-germinal center phenotype and c-MYC rearrangement.
- Staging revealed stage IE disease with extranodal paratesticular involvement.
Implications:
- This case highlights the importance of considering rare differentials for inguinal swelling.
- Early diagnosis and appropriate treatment, such as rituximab-based chemotherapy, can lead to complete remission in paratesticular DLBCL.
Background:
Diffuse large B-cell lymphoma (DLBCL) masquerading as a recurrent inguinal hernia is rare. We report the case of a 73-year-old male patient who presented with a symptomatic bulge in his left groin. Medical history revealed bilateral preperitoneal inguinal hernia repair, osteoporosis and atrial fibrillation. The patient's further history was not significant.
Methods:
Sonography revealed recurrence of an indirect inguinal hernia (4.5 cm × 2.3 cm) on the left, with bilateral subcutaneous lymph nodes that were deemed unremarkable. We planned an elective left-sided anterior inguinal repair. Apixaban was stopped two days prior to surgery.
Results:
During surgery we identified the bulge as a lump attached to the spermatic cord. No hernial sac was present. Together with the consulting urologist, we concluded a possible malignant etiology and performed an orchiectomy along with resection of the lump.
Conclusion:
Microscopic and immunohistochemical analysis revealed a DLBCL with non-germinal center phenotype and c-MYC rearrangement. Further staging confirmed stage IE disease with extranodal paratesticular involvement. The patient was subsequently treated with rituximab in combination with cyclophosphamide, doxorubicin, vincristine, prednisone and showed complete metabolic remission after two cycles. This case illustrates the broad differential diagnosis of inguinal swelling and (para)testicular tumors.
