Peripheral T-Cell Lymphoma, Not Otherwise Specified and Concurrent Seminoma in Testis

Abstract

Concurrent seminoma and malignant lymphoma of the testis is rare. We present a case of concurrent seminoma and peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) in a 54-year-old man who complained of painless left testicular enlargement. Radical left orchiectomy was performed. Macroscopically, the tumor (4.0 × 3.0 cm) was creamy, soft, and homogeneous, and microscopic evaluation revealed an alveolar structure of large cells that formed sheets, as well as colonization by other abnormal cells in a 1.0 × 1.0 cm area. The portion of the tumor comprising large abnormal cells was diagnosed as a seminoma, which was positive for c-kit by immunohistochemistry; the other portion was diagnosed as CD3/CD8, TIA, and granzyme B-positive PTCL-NOS. These two portions were clearly differentiated from one another. The patient received CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy and achieved complete response for 50 months. To our knowledge, this is the first reported case of synchronous advanced seminoma and PTCL.

Chronic lymphocytic leukemia and concurrent seminoma in the same testis

“…Our literature review found a few rare examples of patients with synchronous seminoma and lymphoid neoplasms. All of these patients—including the present one—were aged more than 50 years [ 3 – 6 ]. Singh et al [ 3 ] reported a case of synchronous classical Hodgkin lymphoma in the mediastinal/intraabdominal lymph nodes and right testicular seminoma.…”

“…Jacobsen et al [ 5 ] described a case of metastatic seminoma and concurrent follicular lymphoma, grade 1 in a supraclavicular lymph node. Only one case of concurrent seminoma and PTCL, NOS in the same testis has been reported [ 6 ]. Because of indolent clinical courses of CLL and seminoma, additional/adjuvant therapy was not administered for both tumors in the present case.…”

“…In contrast, less than 5% of testicular neoplasms are malignant lymphomas, most of which are diffuse large B-cell lymphomas (DLBCLs) [2]. As the distribution of age at onset differs between testicular germ cell tumors (20-45 years) and lymphomas (> 50 years) [1,2], only a few reports have described the concurrent and/or synchronous presentation of testicular seminoma and lymphoid neoplasms [3][4][5][6]. Leukemia, including lymphoid and myelogenous subtypes, can also involve testis in a subset of cases [7,8].…”