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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.
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.