Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an int...Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an interesting case of PTL managed by a combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years, consulted for an increase in the volume of the right testicle without associated pain, all evolving in the context of a slight decline in general condition. Clinical examination revealed a large painless mass in the right scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The patient had undergone inguinal orchiectomy. Pathological analysis showed diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET-CT) showed no suspicious hypermetabolism. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The evolution was marked by the death of the patient six months after the end of the scrotal radiotherapy following a diffuse lymph node relapse with a profound alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the disease. The therapeutic approach is multimodal and combined based on orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL is an aggressive malignant with a poor prognosis. Randomized trials are needed to define a better therapeutic strategy.展开更多
Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3%...Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3% to 4% of brain tumors. The most common histological type is diffuse large B-cell lymphoma. Survival is improved by combining immunotherapy with chemotherapy. This is a descriptive retrospective study conducted at the Casablanca hematology center over a period of 9 years. The aim of this study was to report our experience by studying the clinical, paraclinical, therapeutic and evolutionary profile of patients with primary cerebral lymphoma. We present a study of 22 patients with PCL. The clinical, radiological and histological findings are shown along with the results of treatment. Patients were aged 25 - 75 years (mean 47 years) with a male predominance (77%). Computed tomography (CT) scans were performed on 16 patients (73%) and Brain magnetic resonance imaging for 16 patients (73%). Typically, lesions were multiple, isodense, and showed uniform enhancement with contrast medium. Immunocytochemical studies demonstrated 21 B-cell and 1 mantle-cell lymphomas. All patients received chemotherapy through high-dose MTX with whole brain radiotherapy (WBRT). After a median follow-up of 19 months, 54% are in complete remission, 32% have died, and 14% are lost to follow-up. Overall survival at 24 months and 36 months were 72% and 52%. The event-free survival at 24 months and 36 months were 60% and 48%. This study was to investigate the clinical features of PCNSL, and evaluate the efficacy of high-dose methotrexate (MTX)-based chemotherapy for immunocompetent Moroccan patients with PCNSL.展开更多
文摘Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an interesting case of PTL managed by a combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years, consulted for an increase in the volume of the right testicle without associated pain, all evolving in the context of a slight decline in general condition. Clinical examination revealed a large painless mass in the right scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The patient had undergone inguinal orchiectomy. Pathological analysis showed diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET-CT) showed no suspicious hypermetabolism. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The evolution was marked by the death of the patient six months after the end of the scrotal radiotherapy following a diffuse lymph node relapse with a profound alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the disease. The therapeutic approach is multimodal and combined based on orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL is an aggressive malignant with a poor prognosis. Randomized trials are needed to define a better therapeutic strategy.
文摘Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3% to 4% of brain tumors. The most common histological type is diffuse large B-cell lymphoma. Survival is improved by combining immunotherapy with chemotherapy. This is a descriptive retrospective study conducted at the Casablanca hematology center over a period of 9 years. The aim of this study was to report our experience by studying the clinical, paraclinical, therapeutic and evolutionary profile of patients with primary cerebral lymphoma. We present a study of 22 patients with PCL. The clinical, radiological and histological findings are shown along with the results of treatment. Patients were aged 25 - 75 years (mean 47 years) with a male predominance (77%). Computed tomography (CT) scans were performed on 16 patients (73%) and Brain magnetic resonance imaging for 16 patients (73%). Typically, lesions were multiple, isodense, and showed uniform enhancement with contrast medium. Immunocytochemical studies demonstrated 21 B-cell and 1 mantle-cell lymphomas. All patients received chemotherapy through high-dose MTX with whole brain radiotherapy (WBRT). After a median follow-up of 19 months, 54% are in complete remission, 32% have died, and 14% are lost to follow-up. Overall survival at 24 months and 36 months were 72% and 52%. The event-free survival at 24 months and 36 months were 60% and 48%. This study was to investigate the clinical features of PCNSL, and evaluate the efficacy of high-dose methotrexate (MTX)-based chemotherapy for immunocompetent Moroccan patients with PCNSL.
