Panneerselvam Ganesh, Ilangovan Gurubharath, Parthasarathy Ealai A, Anand Rajamani, Joseph Jeffrey S, Khalil-Khan Alam
Department of Radiology, Chettinad Hospital and Research Institute/CARE, Chennai, IND.
Department of Academic Unit of Primary Medical Care, The University of Sheffield, Sheffield, GBR.
Cureus. 2022 Oct 11;14(10):e30182. doi: 10.7759/cureus.30182. eCollection 2022 Oct.
Primary testicular non-Hodgkin's lymphoma (PTNHL) with contiguous involvement of the spermatic cord is a rare occurrence and presentation of the disease, and it mostly involves elderly men between the sixth and eighth decades of life. PTNHL is a rare form of primary testicular malignancy that accounts for 1% of all non-Hodgkin's lymphoma cases and 5-10%of all testicular malignancies. This case report discusses a 73-year-old man who presented with right-sided inguinoscrotal swelling for six months, which had progressively increased in size. The patient was referred to the surgical department, and the examination revealed a hard-palpable mass with thickening of the cord. The initial imaging included an ultrasound, demonstrating a heteroechoic mass inseparable from the right testis with evidence of mild increased internal vascularity. Due to the high suspicion of malignancy, a right orchidectomy was performed. The patient subsequently developed another swelling after seven months, over the right inguinal region, which had progressively increased in size. MRI of the pelvis and CT of the abdomen and chest revealed a lobulated, intermediate intense lesion in the right inguinoscrotal region. This case report demonstrates the importance of radiological imaging in assessing and detecting the characteristics of concomitant lesions by using various imaging modalities and assessing the extent of spread. In addition, radiological imaging helps in the early diagnosis of the disease and facilitates prompt and early treatment to achieve favorable outcomes for the patient. The radiologist should include a differential diagnosis of PTNHL when imaging for a painless inguinoscrotal mass.
原发性睾丸非霍奇金淋巴瘤（PTNHL）合并精索连续受累是一种罕见的疾病表现，主要累及60至80岁的老年男性。PTNHL是原发性睾丸恶性肿瘤的一种罕见形式，占所有非霍奇金淋巴瘤病例的1%，占所有睾丸恶性肿瘤的5 - 10%。本病例报告讨论了一名73岁男性，他右侧腹股沟阴囊肿胀6个月，且肿物逐渐增大。患者被转诊至外科，检查发现可触及坚硬肿物，精索增粗。初始影像学检查包括超声，显示一个与右侧睾丸无法分离的不均匀回声肿物，内部血管有轻度增多迹象。由于高度怀疑为恶性肿瘤，遂行右侧睾丸切除术。7个月后，患者右侧腹股沟区又出现肿胀，且逐渐增大。骨盆MRI及腹部和胸部CT显示右侧腹股沟阴囊区有一个分叶状、中等强度的病变。本病例报告表明，通过使用各种成像方式评估和检测伴随病变的特征以及评估扩散范围，放射学成像在其中具有重要作用。此外，放射学成像有助于疾病的早期诊断，并促进及时和早期治疗，从而为患者带来良好预后。当对无痛性腹股沟阴囊肿物进行成像时，放射科医生应将PTNHL纳入鉴别诊断。
