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TESTICLULAR RECURRENCE OF LYMPHOMA
Authored By: Farrokh Dehdashti and Brandon Peters.
Patient: 43 year old male
History: 43 year old asymptomatic male with history of  precursor T-cell lymphoblastic 
lymphoma presents for follow-up PET/CT after 6 cycles of chemotherapy (HyperVAD + Rituxan). 
Image Size:[small][as-submitted]

Fig. 1
Coronal whole body PET images

Fig. 2
Axial, coronal, and sagittal fused PET/CT images

Fig. 3
Axial non-contrast CT images

Fig. 4
Zoomed image of left testicle with size calipers

Fig. 5
Longitudinal grey scale ultasound image of left testicle

Fig. 6
Color doppler ultrasound image of both testicles to show comparsion

Fig. 7
Power doppler ultrasound image of left testicle
Image Size:[small][as-submitted]

Findings: PET/CT 3/14/07: No metabolic or morphologic evidence of active lymphoma.

Testicular ultrasound 4/18/07:  Markedly enlarged and hyperemic left testicle.
Diagnosis: T-cell ALL recurrence
General Discussion: This is a 43 year old male with a history of precursor T-cell acute lymphocytic lymphoma who had completed 6 cycles of chemotherapy (HyperVAD + Rituxan) who had no signs or symptoms of recurrence at the time of the PET/CT.  The most recent bone marrow biopsy showed no recurrence.  Within a month of the PET/CT the patient subsequently noticed painless swelling of the left side of the scrotum and was evaluated with ultrasound.  Based on an apparent recurrence, a left orchiectomy was performed.  Pathology revealed extensive infiltration of the testicle with T-cell ALL. A bone marrow biopsy revealed marrow recurrence of ALL as well. 
References: PET and PET/CT for response evaluations in lymphoma: current practice and developments.  Leukemia and lymphoma.  2007:Feb 48(2)270-82.
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Additional Details:

Case Number: 206903Owner(s): Farrokh Dehdashti and Brandon PetersLast Updated: 12-07-2011
Anatomy: Genitourinary (GU)   Pathology: Neoplasm
Modality: US, PETAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: ptnm

Case has been viewed 46 times.
Certified by Farrokh Dehdashti on 05-02-2008

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