Unique presentation of testicular involvement in lymphomatoid granulomatosis.
BACKGROUND
Lymphomatoid granulomatosis is a rare angiodestructive B-cell lymphoproliferative disorder associated with Epstein-Barr virus infection. It predominantly affects the lungs, skin, liver, kidneys, spleen, and central nervous system. Testicular involvement has never previously been described. The authors present the first documented case of testicular involvement in lymphomatoid granulomatosis.


METHODS
A 55-year-old gentleman with confirmed lymphomatoid granulomatosis on lung biopsy was noted to have a swelling in his scrotum. Ultrasound scanning demonstrated multiple ill-defined areas of reduced echogenicity throughout both testes with evidence of increased vascularity. Biopsy of the testis confirmed the presence of lymphomatoid granulomatosis. The patient was commenced on alpha-interferon therapy. However, marked clinical improvement occurred only following addition of high-dose oral corticosteroid approximately 1 week later. This resulted in resolution of the testicular swelling and his other symptoms.


CONCLUSIONS
Prognosis with lymphomatoid granulomatosis depends mainly on grade. Our patient responded well to therapy but will continue to be closely followed up in the outpatient setting.
Department of Urology, Ulster Hospital, Dundonald, Dundonald, Belfast, U.K. john.bailie@doctors.org.uk
John
J
Bailie
Benjamin
B
McNaughten
Samuel
S
Gray
Jeremy
J
Hamilton
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D006801:Humans; D008230:Lymphomatoid Granulomatosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013733:Testicular Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones