Oda Yuki, Hashimura Masaya, Ohyama Nobuo
The Department of Urology, Nara Prefecture Seiwa Medical Center.
Hinyokika Kiyo. 2021 Nov;67(11):511-515. doi: 10.14989/ActaUrolJap_67_11_511.
A 66-year-old man came to our department with the chief complaint of a right inguinal painless mass. He was diagnosed with a right spermatic cord tumor and underwent a right high orchiectomy with wide excision. The results of hematoxylin eosin staining and immunostaining procedures showed mucosa-associated lymphoid tissue (MALT) lymphoma originating from the lymphoid tissue of spermatic cord. The patient was referred to the department of hematology at another hospital for treatment. As results of additional immunostaining procedures at that hospital, the pathological diagnosis was diffuse large B-cell lymphoma (DLBCL). The positron emission tomography-computed tomography revealed no residual tumor or metastasis, and the final diagnosis was primary DLBCL Stage I of the spermatic cord. The patient was treated with 6 courses of R-THP-COP, 2 courses of Rituximab, and 3 courses of intrathecal chemotherapy, including Methotrexate, Ara-C, and Prednisolone. In addition, prophylactic radiation therapy to another testis was planned. Primary DLBCL of the spermatic cord is rare, and the standard treatment is the same as that for testicular DLBCL.
一名66岁男性因右侧腹股沟无痛性肿块为主诉前来我院就诊。他被诊断为右侧精索肿瘤，并接受了右侧高位睾丸切除术及广泛切除。苏木精-伊红染色和免疫染色结果显示为起源于精索淋巴组织的黏膜相关淋巴组织（MALT）淋巴瘤。该患者被转诊至另一家医院的血液科进行治疗。根据那家医院进一步免疫染色的结果，病理诊断为弥漫性大B细胞淋巴瘤（DLBCL）。正电子发射断层扫描-计算机断层扫描显示无残留肿瘤或转移，最终诊断为精索原发性DLBCL I期。该患者接受了6个疗程的R-THP-COP、2个疗程的利妥昔单抗以及3个疗程的鞘内化疗，包括甲氨蝶呤、阿糖胞苷和泼尼松龙。此外，计划对另一个睾丸进行预防性放射治疗。精索原发性DLBCL罕见，其标准治疗与睾丸DLBCL相同。
