A case of bilateral testicular malignant lymphoma

Abstract

We report a case of bilateral testicular malignant lymphoma. The patient was a 72-year-old man. He visited our hospital with a chief complaint of indolent swelling of the left scrotal content. Since bilateral testicular tumors and retroperitoneal lymph node metastasis were suspected on the basis of imaging examination findings, bilateral high orchiectomy was performed. On the basis of histopathological examination, the patient was diagnosed as having diffuse large B-cell lymphoma. In the ultrasonography of this patient, the boundaries between the hypoechoic areas indicating the lesions and the normal tissue were relatively clear. The continuity of the tunica albuginea was maintained in the right testis. On the other hand, the hypoechoic areas with unclear boundaries were scattered in patches, the continuity of the tunica albuginea was disrupted, and the outline was irregular in the left testis. It was considered that these findings reflected the degree of necrosis of the testicular tissue and the infiltration of the tumors into the tunica albuginea and epididymis. The color Doppler method showed abundant blood flow in both testes, which suggested bilateral malignant lymphomas. Therefore, it is important to observe the outline of the testis and the continuity of the tunica albuginea as well as the inner part of the testis and to evaluate the blood flow by the color Doppler method when performing ultrasonography of the scrotal content.