睾丸悪性リンパ腫の2例

Abstract

Two cases of malignant lymphoma arising from the testis are reported. Case 1: A 70-year-old man presented with a painless swelling of the right scrotal contents. Right radical orchiectomy was done and histological examination revealed malignant lymphoma of the testis (diffuse lymphoma, mixed type). Bipedal lymphangiography and CT scan showed metastatic lesion in the right retroperitoneal lymph-nodes. Postoperative irradiation to the inverted Y field encompassing the para-aortic, pelvic and inguinal lymph-nodes bilaterally was given to a total dose of 5, 000 rad, and treatment with anti-cancer agents was subsequently started. The patient, however, died of liver failure about 6 months after the operation. Case 2: A 74-year-old man presented with painless right scrotal swelling. Right orchiectomy was performed and the tumor histologically appeared to be anaplastic seminoma. The patient received 3, 000 rad of irradiation to the retroperitoneal space. There was no evidence of metastasis, until he developed swelling of the right inguinal lymph-nodes about 5 months after the operation. Afterwards, multiple skin tumors in the legs appeared. Biopsy of the skin lesions showed metastasis of malignant lymphoma (diffuse lymphoma, large cell type). The right testis removed previously was then reviewed in detail, and primary malignant lymphoma of the testis was strongly suggested. The patient responded poorly to additional irradiation or cancer chemotherapy and died about one year and 3 months after the right orchiectomy. A statistical survey was made on 117 cases of malignant lymphoma of the testis reported in Japan and the discussion is focused on the significance of new histological classification in relation to the prognosis.