Primary NK/T cell lymphoma of the testis. A case report and review of the literature.
We report a case of aggressive 'nasal type' natural killer (NK)/T cell lymphoma initially presenting as a testicular tumor in a Korean man, which quickly took a fatal course by widespread dissemination. Histologically, the testicular mass showed a diffuse dense infiltrate of medium-sized and atypical large lymphoid cells with angiocentric and angiodestructive infiltration and areas of coagulative necrosis on hematoxylin-eosin stained sections. Immunophenotyping by immunohistochemistry yielded surface markers consistent with NK/T cell lymphoma. The Epstein-Barr virus genome was detected by in situ hybridization. During involved-field irradiation and chemotherapy following radical orchiectomy, the tumor disseminated shortly to the skin and soft tissue of his anterior chest wall and central nervous system (CNS). Identical lymphoid infiltrates were present in the patient's skin. CNS involvement was interpreted as having a leptomeningeal seeding. To the best of our knowledge, this is the 9th reported case of confirmed NK/T cell lymphoma arising from the testis. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.
Kim
Yong Bae
YB
Department of Radiation Oncology, Brain Korea 21 Project for Medical Sciences, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Chang
Sei Kyung
SK
Yang
Woo-Ick
WI
Hahn
Jee Sook
JS
Koom
Woong Soup
WS
Shim
Su Jung
SJ
Park
Won
W
Lee
Kang Kyoo
KK
Suh
Chang Ok
CO
Kim
Gwi Eon
GE
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002490:Central Nervous System / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017403:In Situ Hybridization; D007694:Killer Cells, Natural; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009336:Necrosis; D009362:Neoplasm Metastasis; D009919:Orchiectomy; D011241:Prednisone / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis; D011878:Radiotherapy; D012008:Recurrence; D012867:Skin / Q000473:pathology; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D035441:Thoracic Wall / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014750:Vincristine / Q000627:therapeutic use
D012367:RNA, Viral; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate