Naboush Ali, Farhat Firas, Nasser Selim M, Kamar Francois G
Staten Island University Hospital, NY, USA.
Case Rep Oncol Med. 2013;2013:267389. doi: 10.1155/2013/267389. Epub 2013 Aug 12.
Introduction. Testicular lymphoma is an aggressive disease with a very poor prognosis. Nasal-type natural killer/T-cell lymphoma (NKTCL-N) in particular is very uncommon and has a rapidly progressive, fatal course. Case Report. We report a case of primary NKTCL-N of the testis in a 38-years-old Middle Eastern man. The patient had a history of primary right testicular tumor diagnosed at an outside institution as a seminoma and treated with orchiectomy followed by chemo/radiation. On admission, the patient had an enormous nasal granuloma with blood workup showing pancytopenia and elevated liver function tests due to active hepatitis B infection. CT scan of the sinuses showed a very large soft tissue mass, and PET scan showed splenomegaly with multiple lymph node masses in the pelvis and the chest areas. Bone marrow and nasal tumor biopsies as well as review of the slides from the initial orchiectomy were all in favor of NKTCL-N lymphoma. The patient was treated with CHOD based combination chemotherapy and responded dramatically to the first two cycles but passed away from fulminant hepatitis B infection. Conclusion. Despite all known treatments of NKTCL-N lymphoma of the testes, this disease has a very poor prognosis and invariably follows an aggressive clinical course.
引言。睾丸淋巴瘤是一种侵袭性疾病，预后很差。特别是鼻型自然杀伤/T细胞淋巴瘤（NKTCL-N）非常罕见，病程进展迅速且致命。病例报告。我们报告一例38岁中东男性原发性睾丸NKTCL-N病例。该患者有原发性右侧睾丸肿瘤病史，在外院被诊断为精原细胞瘤，接受了睾丸切除术，随后进行化疗/放疗。入院时，患者有巨大鼻肉芽肿，血液检查显示全血细胞减少，由于活动性乙型肝炎感染肝功能检查结果升高。鼻窦CT扫描显示一个非常大的软组织肿块，PET扫描显示脾肿大，骨盆和胸部区域有多个淋巴结肿块。骨髓和鼻肿瘤活检以及对最初睾丸切除术后切片的复查均支持NKTCL-N淋巴瘤。该患者接受了基于CHOD的联合化疗，对前两个周期反应显著，但因暴发性乙型肝炎感染去世。结论。尽管对睾丸NKTCL-N淋巴瘤有所有已知的治疗方法，但这种疾病预后很差，临床病程总是很凶险。
