title: Unusually Aggressive Primary Testicular Diffuse Large B Cell Lymphoma with Post Therapy Extensive Metastasis.
abstract: Primary Testicular Lymphoma (PTL) is a rare intermediate to high grade tumour, diffuse large cell being the most common type. Unlike nodal Diffuse Large B-Cell Lymphoma (DLBCL), testicular DLBCL has a less aggressive course and better prognosis. Metastasis is uncommon in testicular DLBCL. Commonly involved sites are contralateral testes, Waldeyer's ring, skin, lung, Central Nervous System (CNS) and prostate, however the kidneys, liver, bone marrow, pleura and bones are more rarely involved. We report a case of testicular DLBCL which has metastasized to skin and bone marrow with an aggressive clinical course in a year, in-spite of combined modality of therapy given to the patient. Bone marrow infiltration is common and well documented with nodal DLBCL, however there is no published literature for simultaneous bone marrow and skin infiltration in testicular DLBCL till date. Other large studies done in the west have shown that distinct metastasis is usually common but the median progression-free survival is usually in years. This case stresses on shorter period of progression after standard treatment protocol in this part of the world, thus highlighting the need for other extensive studies to define specific treatment protocol for testicular DLBCL.
authors.affiliation: Associate Consultant, Department of Pathology and Laboratory Medicine, Medanta- The Medicity Hospital , Sector 38, Gurgaon, India .
authors.forename: Shalini
authors.initials: S
authors.lastname: Goel
authors.affiliation: Senior Consultant, Department of Pathology and Laboratory Medicine, Medanta- The Medicity Hospital , Sector 38, Gurgaon, India .
authors.forename: Ritesh
authors.initials: R
authors.lastname: Sachdev
authors.affiliation: Consultant, Department of Pathology and Laboratory Medicine, Medanta- The Medicity Hospital , Sector 38, Gurgaon, India .
authors.forename: Ishani
authors.initials: I
authors.lastname: Mohapatra
authors.affiliation: Associate Consultant, Department of Pathology and Laboratory Medicine, Medanta- The Medicity Hospital , Sector 38, Gurgaon, India .
authors.forename: Smeeta
authors.initials: S
authors.lastname: Gajendra
authors.affiliation: Associate Consultant, Department of Medical Oncology and Hematology, Medanta- The Medicity Hospital , Sector 38, Gurgaon, India .
authors.forename: Sunil
authors.initials: S
authors.lastname: Gupta
keywords: CNS metastasis; Lung metastasis; Positron Emission Tomography-Computed Tomography (PET-CT)