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Testicular Lymphoma : Subtypes

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Testicular Lymphoma Subtypes: The vast majority of primary testicular lymphomas in adults (80-90% of cases) are diffuse large B-cell lymphomas. Uncommon subtypes include follicular lymphoma, nasal-type extranodal NK/T-cell lymphoma, Burkitt lymphoma, plasmablastic lymphoma, lymphoblastic lymphoma, peripheral T-cell lymphoma, and anaplastic large cell lymphoma.

Primary testicular lymphomas are rare in children and usually consist of Burkitt lymphoma or localized follicular lymphoma. Some cases have a minor component of diffuse large B-cell lymphoma.

Hodgkin lymphoma is extremely uncommon in the testis. Rare instances of plasmacytoma have been reported in the testis. Lymphomas arising elsewhere may also secondarily involve testis and paratesticular structures.

Case History: This orchiectomy is from a 50+ y/o male with a slowly enlarging testis. Ultrasound showed a solid vascular mass consistent with a neoplasm. Serum tumor markers (AFP, beta-hCG, LDH) were within reference range. The cut surface shows a yellow-tan multinodular tumor replacing most of the testis leaving a thin rim of uninvolved brown parenchyma at the upper pole. The tumor cells were strongly positive for CD45 and pan B-cell markers and negative for CD3. Ki-67 labeling index was high. Final diagnosis - Primary Diffuse Large B-cell Lymphoma of the Testis.

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