精巣上体悪性リンパ腫の1例

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症例:17歳男.左陰嚢内容の腫大を主訴とした.左陰嚢内,左精巣上極に約2cm大の表面不整,硬い腫瘤を触知した.超音波検査では腫瘤は充実性腫瘍であった.悪性腫瘍の可能性を考えて,手術を施行した.精巣と精巣上体との剥離は困難と考え,左高位精巣摘除術を施行した.病理組織学的に精巣上体原発の非ホジキンリンパ腫,瀰漫性混合細胞型,B細胞型の悪性リンパ腫と診断された.術後化学療法を3コース施行した.現在治療開始26ヵ月であるが,全身状態は良好で再発や転移を認めず生存中であるA 17-year-old man visited our hospital with the chief complaint of painless swelling of the left scrotal content. An elastic hard mass was palpable at the upper pole of the left testis. Left radical orchiectomy was performed. The tumor originated from the epididymis and did not involve the testis or the spermatic cord. Histologically, the tumor was diagnosed as a malignant lymphoma (non-Hodgkin's lymphoma, diffuse mixed cell type, B-cell type). No abnormalities were found in other organs. After establishment of the diagnosis of primary epididymal malignant lymphoma, 3 courses of chemotherapy (adriamycin, vincristine, cyclophosphamide, prednisolone) were performed. No evidence of recurrence or metastasis was found 26 months after surgery.