Wang Yongren, Li Jian, Fang Yongjun
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University.
Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2020 Jun 26;99(26):e20861. doi: 10.1097/MD.0000000000020861.
Primary non-Hodgkin lymphoma (NHL) of the testes is rare, representing about 9% of testicular neoplasms and 1% to 2% of non-Hodgkin lymphomas.
A previously healthy 47-month-old boy came to our institution for 3 months unilateral testicular swelling without tenderness. After preliminary examination, inguinal orchiectomy was performed to resect the right scrotal mass. The histopathological diagnosis of high-grade lymphoma was rendered and paraffin blocks were sent for immunophenotyping.
The final diagnosis by histopathological combined with immunohistochemical staining revealed primary testicular T-cell lymphoblastic lymphoma (St Jude Children's Research Hospital Staging System, stage I).
The patient was treated with right inguinal orchidectomy followed by chemotherapy (SMCC-2011 protocol modified based on the BFM-90/95 regimen from Germany) without prophylactic radiotherapy to the contralateral testis.
After 36 months of follow-up, the patient is now disease-free without any complication.
T-lymphoblastic lymphoma should be considered in the differential diagnosis of testicular masses in children. Intensive chemotherapy may improve the prognosis of such patients.
睾丸原发性非霍奇金淋巴瘤（NHL）较为罕见，约占睾丸肿瘤的9%，非霍奇金淋巴瘤的1%至2%。
一名此前健康的47个月大男孩因单侧睾丸肿胀3个月且无压痛前来我院。初步检查后，行腹股沟睾丸切除术切除右侧阴囊肿物。组织病理学诊断为高级别淋巴瘤，并送石蜡块进行免疫表型分析。
组织病理学结合免疫组化染色的最终诊断为原发性睾丸T细胞淋巴母细胞淋巴瘤（圣裘德儿童研究医院分期系统，I期）。
患者接受了右侧腹股沟睾丸切除术，随后进行化疗（基于德国BFM - 90/95方案改良的SMCC - 2011方案），未对侧睾丸进行预防性放疗。
经过36个月的随访，患者目前无病，无任何并发症。
儿童睾丸肿物的鉴别诊断应考虑T淋巴母细胞淋巴瘤。强化化疗可能改善此类患者的预后。
