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Natural killer cell lymphoma in cytology: breaking all the rules--a case report
C A Wright1, K Cooper, G Leiman
1Department of Anatomical Pathology, School of Pathology, South African Institute for Medical Research, University of the Witwatersrand, Johannesburg, South Africa.
Insights
This study describes the first reported cytologic case of CD 56-positive T-natural killer cell lymphoma in a testicular mass aspirate. The findings highlight challenges in differentiating this rare lymphoma from germ-cell tumors based solely on cytology.
Area of Science:
- Hematology
- Oncology
- Cytopathology
Background:
- Non-Hodgkin's lymphoma can present with extranodal involvement, including the testes.
- Accurate cytologic diagnosis of testicular masses is crucial for appropriate patient management.
Observation:
- A testicular mass aspirate from a 22-year-old patient with known non-Hodgkin's lymphoma revealed large, pleomorphic cells in syncytial fragments with abundant cytoplasm.
- Absence of typical lymphoma criteria and lymphoglandular bodies led to an initial differential diagnosis of germ-cell tumor.
Findings:
- Histopathology confirmed the diagnosis as CD 56-positive (large-cell) T-natural killer cell lymphoma.
- This represents the first cytologically described and illustrated case of this specific lymphoma subtype in a testicular aspirate.
Implications:
- Cytologic evaluation of testicular masses requires awareness of rare T-natural killer cell lymphomas.
- Distinguishing T-natural killer cell lymphoma from germ-cell tumors on initial aspiration is critical for timely and accurate diagnosis.
Abstract:
A testicular mass aspirate was received from a 22-yr-old patient with known non-Hodgkin's lymphoma. The cells were large and pleomorphic, occurring in syncytial fragments and demonstrating abundant cytoplasm. No lymphoglandular bodies were seen. As characteristic lymphoma criteria were not present, a cytodiagnosis of germ-cell tumor was suggested, and testicular biopsy advised. The final histopathology report, however, was of a CD 56-positive (large-cell) T-natural killer cell lymphoma, of which this appears to be the first example described and illustrated cytologically.
