Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In this study, the case of an isolated testicular B-lymphoblastic lymphoma in a 9-year-old boy is discussed with an emphasis on the difficulties in diagnosing and treating such an unusual presentation. This example illustrates the importance of considering lymphoblastic lymphoma in the differential diagnosis of an unidentified source of testicular enlargement. Furthermore, it highlights the possible efficacy of systemic chemotherapy with or without surgical excision. The article advances our knowledge of this unusual clinical situation.

There are 1% to 2% of lymphoma cases that include the testis as primary testicular non-Hodgkin lymphoma (NHL). In 35% of cases, it involves both testes and is usually seen as a painless testicular mass. Therefore, in most cases, the management option is radical orchiectomy. The overall prognosis in these cases is poor, as most cases are associated with systemic disease. We report a case of a 42-year-old male who presented with painless right scrotal swelling for three months. The only serologic marker of solid tumors that was elevated was βHCG; others were unremarkable. Ultrasonography was initially ordered as well and showed a heterogeneous intra-testicular lesion of relatively low echogenicity. According to the given age, epidemiology, and clinical presentation, the suspicion of a germ cell tumor was highly likely. Therefore, a right radical inguinal orchiectomy was done, and the specimen was sent for histopathology, which came back as B-cell non-Hodgkin lymphoma. The clinical presentation and the overall picture of the investigations made in this case mimicked a germ cell tumor presentation.

Mantle cell lymphoma (MCL) with testicular involvement is a rare presentation and only a few cases have been described in the literature. We present a case of MCL with testicular involvement and the first analysis of all previously reported cases assessing trends in immunohistochemical features, prognostic indicators, and survival. Our data suggest that among all MCL, testicular MCL is more likely to present with aggressive features: blastoid/pleomorphic morphology, high Ki-67 proliferative index, and CNS involvement. Testicular MCL is also associated with shorter overall survival.

BACKGROUND: Primary testicular lymphoma (PTL) rarely presents as acute scrotal swelling. It is a very aggressive form of extra nodal non-Hodgkin\'s lymphoma. It accounts for less than 9 % of all testicular tumours. There are limited data characterizing this entity and this case report aim to add to existing literature.
METHODS: A 40-year-old patient, with a history of a pulmonary tuberculosis declared cured, presented a scrotal swelling that set rapidly in less than a week evolving in a context of weight loss and fever. The clinical examination was tender and hard on palpation while ultrasound revealed a suspicious oval formation not taking colour in Doppler. The patient underwent a right inguinal orchidectomy due to suspicious clinical presentation.
UNASSIGNED: MHNL are very rare causes of acute scrotal swelling representing approximately 1 %. It\'s an aggressive tumour and remains rare in young men. Diagnosis is purely histological. Standard treatment includes orchidectomy, chemotherapy with a poor prognosis.
CONCLUSIONS: PTL can reoccur years after complete remission. It\'s related to an expression of diffuse lymphomatosis suggesting an aggressive approach. Its management is multidisciplinary based on the tumour\'s stage according to Ann Arbor classification.

Primary testicular lymphoma is the common testicular neoplasm in patients aged more than 65 years. It accounts for a small number of cases of adult testicular malignancies. Though the metastasis to bone marrow, liver, and central nervous system are well known, metastasis to adrenal glands is a very rare entity. It can be mistaken as a germ cell tumor or a dual malignancy. To rule out other causes, a multidisciplinary approach is required. Here, we present a rare case of primary testicular Non-Hodgkin\'s lymphoma with bilateral adrenal metastasis.

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BACKGROUND: The testis may be infiltrated by hematological neoplasias. However, only few entities present as primary testicular diseases.
OBJECTIVE: To present hematological neoplasias in the testis, especially primary testicular hematological diseases.
METHODS: Selective literature research ( http://www.ncbi.nlm.nih.gov ) was combined with the clinico-pathological experience of the authors.
RESULTS: We present the experience of the lymph node registry Kiel with hematological neoplasias of the testis and develop a staining recommendation. According to our data, the testis is mainly involved by diffuse large B‑cell lymphomas (~70% of cases) followed by precursor cell neoplasias (~20%). Most precursor cell neoplasias are disseminated diseases involving the testis. Primary testicular lymphomas are nearly exclusively diffuse large B‑cell lymphomas that show specific clinical, pathological, and molecular features discriminating them from nodal/disseminated lymphomas. Primary testicular follicular lymphomas, which have been described in the literature, seem to be extremely rare.
CONCLUSIONS: Primary testicular lymphomas are predominantly diffuse large B‑cell lymphomas. The diagnosis is possible with few immunohistochemical stainings. However, histology cannot replace clinical staging to discriminate primary testicular lymphoma from secondary infiltration by a nodal/disseminated disease.
UNASSIGNED: HINTERGRUND: Die Hoden können von hämatologischen Neoplasien infiltriert werden, aber nur wenige Erkrankungen treten als primär testikuläre (auf den Hoden beschränkte) Erkrankungen auf.
UNASSIGNED: Darstellung hämatologischer Neoplasien im Hoden, insbesondere der primär testikulären Lymphome.
METHODS: Eine selektive Literaturrecherche ( http://www.ncbi.nlm.nih.gov ) wurde mit den praktischen Erfahrungen der Autor*Innen aus der klinisch-pathologischen Diagnostik kombiniert.
UNASSIGNED: Wir zeigen die Erfahrungen mit hämatologischen Infiltraten im Hoden innerhalb des Lymphknotenregisters Kiel und leiten daraus eine Färbeempfehlung ab. Nach unseren Daten sind im Hoden überwiegend diffuse großzellige B‑Zell-Lymphome (ca. 70 %) gefolgt von lymphatischen und myeloischen Vorläuferzellneoplasien (ca. 20 %) zu finden. Die meisten Vorläuferzellneoplasien sind disseminierte Erkrankungen mit Hodenbeteiligung. Primär testikuläre Lymphome sind fast ausschließlich diffuse großzellige B‑Zell-Lymphome. Diese Erkrankungen zeigen klinisch, pathologisch und molekular besondere Eigenschaften, die sie von den nodalen/disseminierten Lymphomen unterscheiden. Das in der Literatur beschriebene primär testikuläre follikuläre Lymphom scheint eine Rarität darzustellen.
UNASSIGNED: Primär testikuläre Lymphome sind überwiegend diffuse großzellige B‑Zell-Lymphome. Sie können mit wenigen orientierenden Färbungen identifiziert werden. Zur Abgrenzung gegenüber nodalen/disseminierten Lymphomen kann die Histologie eine Ausbreitungsdiagnostik (Staging) nicht ersetzen.

UNASSIGNED: To report two cases of vitreoretinal lymphoma that developed following primary testicular lymphoma and review the literature.
UNASSIGNED: Two men, one age 66 and the other age 77, both with a history of diffuse large B-cell testicular lymphoma, diagnosed one and three years previously, respectively, presented with vitritis and yellow-white subretinal infiltrates. Diagnostic vitrectomy in both cases revealed diffuse large B-cell lymphoma. Systemic work up in both cases showed no evidence of disease relapse elsewhere. Each were treated with intravitreal methotrexate injections.
UNASSIGNED: Vitreoretinal lymphoma can occur following primary testicular lymphoma, and may mimic primary vitreoretinal lymphoma. Monitoring of patients with a history of testicular lymphoma with regular dilated fundus examinations should be considered.

Although treatment for diffuse large B-cell lymphoma (DLBCL) has taken some notable steps in the 2000s, there are still subgroups of patients suffering from high mortality and relapse rates. To further improve treatment outcomes, it is essential to discover new mechanisms of chemotherapy resistance and create new treatment approaches to overcome them. In the present study, we analyzed the expression of chemokines and their ligands in systemic and testicular DLBCL. From our biopsy sample set of 21 testicular and 28 systemic lymphomas, we were able to demonstrate chemokine profile differences and identify associations with clinical risk factors. High cytoplasmic CXCL13 expression had correlations with better treatment response, lower disease-related mortality, and limited stage. This study suggests that active CXCR5/CXCL13 signaling could overtake the CXCR4/CXCL12 axis, resulting in a better prognosis.

Low absolute lymphocyte counts (ALC) and high absolute monocyte counts (AMC) are associated with poor survival in patients with diffuse large B-cell lymphoma (DLBCL). We studied the prognostic impact of the ALC and AMC in patients with testicular DLBCL (T-DLBCL). T-DLBCL patients were searched using Southern Finland University Hospital databases and the Danish lymphoma registry. The progression free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier and Cox proportional hazards methods. We identified 178 T-DLBCL patients, of whom 78 (44%) had a low ALC at diagnosis. The ALC did not correlate with survival in the whole cohort. However, among the patients treated with rituximab (R) containing regimen, a pre-therapeutic low ALC was associated with an increased risk of progression (HR 1.976, 95% CI 1.267-3.086, p = 0.003). Conversely, intravenous (iv) CNS directed chemotherapy translated to favorable outcome. In multivariate analyses, the advantage of an iv CNS directed chemotherapy was sustained (PFS, HR 0.364, 95% CI 0.175-0.757, p = 0.007). The benefit of R and intravenous CNS directed chemotherapy was observed only in non-lymphopenic patients. The AMC did not correlate with survival. A low ALC is an adverse prognostic factor in patients with T-DLBCL. Alternative treatment options for lymphopenic patients are needed.