Yoshida Kenta, Uemura Koichi, Inoue Masahiro, Mizuno Nobuhiko, Murakami Takayuki, Tsuchiya Futoshi
The Department of Urology, Yokohama City Minato Red Cross Hospital.
Hinyokika Kiyo. 2018 Nov;64(11):459-463. doi: 10.14989/ActaUrolJap_64_11_459.
A 68-year-old man with swelling of his left testis was referred to our hospital. There was no history of hematologic disease. The diameter of the testicular mass was 40 mm. We performed a left orchiectomy. Histopathologic examination revealed diffuse infiltration of immature neoplastic cells with a high nuclearcytoplasmic ratio. Immunohistochemical analysis revealed that cells were positive for myeloperoxidase, while T-cell and B-cell markers were negative. There was no evidence of leukemia cells in peripheral blood or in bone marrow. The tumor was diagnosed as a testicular isolated myeloid sarcoma. Eleven months after the orchiectomy, enlargement of the para-aortic lymph node occurred. There was no evidence of leukemia cells in the peripheral blood or bone marrow. The patient is undergoing chemotherapy for recurrence of myeloid sarcoma. Myeloid sarcoma is an extramedullary tumor composed of immature myeloid cells. Myeloid sarcoma primarily involving the testis is rare. However, it is important to consider it as a differential diagnosis because it has a poor prognosis.
一名68岁左侧睾丸肿大的男性被转诊至我院。他无血液系统疾病史。睾丸肿块直径为40毫米。我们实施了左侧睾丸切除术。组织病理学检查显示未成熟肿瘤细胞弥漫浸润,核质比高。免疫组织化学分析显示细胞髓过氧化物酶呈阳性,而T细胞和B细胞标志物呈阴性。外周血和骨髓中均无白血病细胞证据。该肿瘤被诊断为睾丸孤立性髓系肉瘤。睾丸切除术后11个月,腹主动脉旁淋巴结肿大。外周血和骨髓中均无白血病细胞证据。该患者正在接受针对髓系肉瘤复发的化疗。髓系肉瘤是一种由未成熟髓样细胞组成的髓外肿瘤。主要累及睾丸的髓系肉瘤很罕见。然而,将其作为鉴别诊断很重要,因为其预后较差。