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Testicular Lymphoma : Gross

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Testicular Lymphoma - Gross Pathology: In orchiectomy specimens, testicular lymphomas appear as discrete, firm or fleshy, yellow-tan/white/grey nodules ranging in size from < 1 cm to > 10 cm. The tumor may replace the entire testis, sometimes leaving only a thin rim of uninvolved parenchyma (as in this case). Foci of necrosis may be present.

Testicular lymphomas can mimic seminomas grossly; however, they are more likely to show extratesticular spread as compared to seminomas. Lymphomas penetrate through tunica albuginea in about 50% of cases. Epididymis is involved in the majority of cases. Rare cases show spermatic cord involvement.

Case History: This orchiectomy shows a diffuse large B-cell lymphoma of the testis in an elderly male (> 80 years). The patient presented with testicular discomfort. Ultrasound findings were concerning for a mass. Serum tumor markers (AFP, beta-hCG, and LDH) were within reference range. The tumor was composed of large atypical lymphoid cells that were positive for CD45 and CD20 and negative for CD3 and CD30.

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