精巣上体腫瘍により発見された悪性リンパ腫の1例

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症例は56歳男で,右陰嚢内容の無痛性腫大を主訴とした.右陰嚢内,精巣上体に5cm大の表面平滑,右様硬の腫瘤を触知した.右精巣摘除術を施行した.組織学的に精巣上体腫瘍は非Hodgkin悪性リンパ腫と診断された.精巣・精索には異常はなかった.術後CTにて上腹部横隔膜近傍に傍大動脈リンパ節腫大と左上肺野に2cm大の腫瘤影を認めた.悪性リンパ腫に対し化学療法を施行し,その後左肺上葉切除術を施行した.腫瘍経は3cm大,病理診断は中分化型腺癌であった.精巣摘除術8ヵ月後に,原因不明のまま急死したA 56-year-old man visited our hospital with the complaint of painless swelling of right scrotal contents. Right orchiectomy was performed. Histopathological diagnosis was malignant lymphoma of the epididymis, without involvement of the testis. Bone marrow biopsy and Ga scintigram showed a normal pattern, while a swollen retroperitoneal lymph node (3 cm) was found by computed tomography (CT). The CT also showed a small mass lesion in the left upper lung field. After 2 courses of chemotherapy for malignant lymphoma, left upper lobectomy was performed at another clinic. Pathological diagnosis of the surgical specimen was moderately differentiated adenocarcinoma. The patient died without known causes, 8 months after the orchiectomy.