Positive hydrocele cytology accompanying testis seminoma

Roy, Clyde R.; Peterson, Norman E.

doi:10.1016/0090-4295(92)90310-s

Cited by 8 publications

(7 citation statements)

References 2 publications

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“…Hydrocele in a case of testicular malignancy may arise due to either lymphatic occlusion by the lymph nodes/tumor or direct infiltration of malignant cells into the hydrocele cavity. 7 Absence of intra-abdominal lymphadenopathy and normal testes ruled out first mechanism in our case. We hypothesize that our patient had microscopic testicular infiltration, not evident on USG, and malignant hydrocele resulted from contiguous spread.…”

Section: Discussionsupporting

confidence: 52%

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Cytopathological Diagnosis of an Unusual Cause of Malignant Hydrocele

Jain

Khadwal

Prakash

et al. 2016

Clin Med�Insights�Pathol

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Testicular involvement in a case of acute lymphoblastic leukemia (ALL) is well reported, but occurrence of “isolated” malignant hydrocele is extremely uncommon. We herein report a case of a 22-year-old man who presented to our hematology clinic with fever and easy fatiguability of 2 weeks’ duration. Examination revealed pallor, cervical lymphadenopathy, and bilateral scrotal swellings. He was diagnosed as a case of Philadelphia-positive ALL (B-cell type) based on peripheral smear, bone marrow examination, and flow cytometry of the marrow aspirate. Ultrasonography of scrotum revealed bilateral hydrocele with normal testes. Cytopathological analysis of the hydrocele fluid showed the presence of lymphoblasts. The patient was treated with modified BFM-90 protocol along with imatinib mesylate (600 mg/day). He achieved complete remission with a minimal residual disease of <0.001% at the end of induction therapy. However, the hydrocele persisted and a repeat cytological examination of the aspirate did not reveal any lymphoblasts. The patient was treated with consolidation (high-dose methotrexate), bilateral testicular irradiation, and re-induction following which the hydrocele disappeared. The patient is currently on maintenance phase of BFM-90 protocol and is alive at one year of follow-up. Contiguous spread from the subclinical testicular involvement is hypothesized as the mechanism for development of hydrocele in the current case. The role of cytopathology in the early diagnosis of testicular involvement in ALL is emphasized here.

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Section: Discussionsupporting

confidence: 52%

“…Malignant hydrocele has been reported in association with seminoma and mesothelioma of tunica vaginalis previously. 7 , 8 Pre-operative cytological diagnosis in such cases may influence the choice of operative procedure (scrotal v/s inguinal). Occurrence of malignant hydrocele in ALL is extremely unusual.…”

Section: Discussionmentioning

confidence: 99%

Cytopathological Diagnosis of an Unusual Cause of Malignant Hydrocele

Jain

Khadwal

Prakash

et al. 2016

Clin Med�Insights�Pathol

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“…1,4 There is only one report where the preoperative diagnosis of testicular plasmacytoma was made based on the hydrocele fluid cytology, 1 although most of preoperative diagnoses of malignant testicular tumors based on hydrocele fluid cytology have been made in malignant mesothelioma and seminoma. 5 Even though image analysis with ultrasonography, computed tomography and magnetic resonance imaging has been developed, hydrocele fluid cytology would be of help for preoperative diagnosis when the fluid is not clear or testicular tumor is suspected, as shown in the present case.…”

Section: Discussionmentioning

confidence: 75%

“…Previous reports of testicular plasmacytoma showed that a painless testicular swelling is the most common chief complaint, although hydrocele of the testis as a chief complaint was found in two cases 1,4 . There is only one report where the preoperative diagnosis of testicular plasmacytoma was made based on the hydrocele fluid cytology, 1 although most of preoperative diagnoses of malignant testicular tumors based on hydrocele fluid cytology have been made in malignant mesothelioma and seminoma 5 …”

Section: Discussionmentioning

confidence: 99%

Primary testicular plasmacytoma with hydrocele of the testis

et al. 2001

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A case of primary testicular plasmacytoma complicated with hydrocele of the testis is reported. An 86-year-old man presented with hydrocele of the right testis. High inguinal orchiectomy was performed as the preoperative aspiration cytology of the hydrocele fluid showed atypical cells. Immunohistochemical study of the right testis revealed testicular plasmacytoma positive for IgG. He remained well 9 months after the orchiectomy. This is the second reported case where the preoperative diagnosis of testicular plasmacytoma was made based on the hydrocele fluid cytology.

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“…A total of 59 patients were seen for sclerotherapy of hydroceles. Of these, 22 were excluded from the study for the following reasons: lost records (9); specimen reached laboratory too late (8); and the hydrocele was of a secondary nature (5). Therefore 37 patients were left in the hydrocele group.…”

Section: Methodsmentioning

confidence: 99%