Cancer Res Treat.  2007 Mar;39(1):40-43.

Orbital Infiltration as the First Site of Relapse of Primary Testicular T-cell Lymphoma

• Jun HJ
• Kim WS
• Yang JH
• Yi SY
• Ko YH
• Lee J
• Jung CW
• Kang SW
• Park K

Abstract

A 43-year-old male presented with a painless left testicular mass. The pathologic diagnosis of the radical orchiectomy specimen was peripheral T-cell lymphoma, unspecified (PTCL-u). According to the Ann Arbor staging system, his initial stage was III because of the right nasopharyngeal involvement. After first-line chemotherapy with four courses of the CHOP regimen and this was followed by involved-field radiotherapy, he achieved complete remission. Two months later, disease recurred to the left ciliary body of the left eye without evidence of involvement at other sites. Although the patient received intensive chemotherapy with autologous hema-topoietic stem cell transplantation, he ultimately died of leptomeningeal seeding. Because both the central nervous system (CNS) and the orbit are sanctuary sites for chemotherapy, orbital infiltration of lymphoma should prompt physicians to evaluate involvement of the CNS and to consider performing prophylactic intrathecal chemotherapy as a treatment option.

Keyword

Non-Hodgkin's lymphoma; T cell lymphoma; Testes; Eye neoplasm

MeSH Terms

Adult
Central Nervous System
Ciliary Body
Diagnosis
Drug Therapy
Eye Neoplasms
Humans
Lymphoma
Lymphoma, Non-Hodgkin
Lymphoma, T-Cell*
Lymphoma, T-Cell, Peripheral
Male
Orbit*
Orchiectomy
Radiotherapy
Recurrence*
Stem Cell Transplantation
T-Lymphocytes*
Testis

Figure

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  Fig. 1 CT scan of the pelvis showed the heterogeneously enhancing mass that originated from the left testicle.

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  Fig. 2 Orchiectomy specimen of the left testis showed malignant lymphoma with focal angioinvasion, and this was consistant with peripheral T cell lymphoma (A: H&E, ×400), and the positive immunohistochemical staining with CD3 (B: ×400), and CD56 (C: ×400).

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  Fig. 3 Nasopharynx CT displayed polyphoid lesion of the right nasopharynx.

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  Fig. 4 Nasopharynx biopsy revealed the involvement of peripheral T cell lymphoma (H&E, ×400).

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  Fig. 5 Pseudohypopyon of the left eye.

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  Fig. 6 Aspiration of the anterior chamber showed atypical lymphocytes with mercury drop-like apoptotic bodies, suggestive of lymphomatous cells (H&E, A: ×40, B: ×200).

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  Fig. 7 Brain MRI demonstrated parenchimal enhancement of the cerebellum (A), linear enhancement at the anterior aspect of both cerebral peduncles (B) and tiny enhancing foci of the left parietal cortex (C).

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