A Primary Testicular Diffuse Large B-cell Lymphoma Belonging to the Germinal Center B-cell-like Group.

UNLABELLED: Testicular lymphoma was first reported by Malassez and Curling in 1866. Primary testicular lymphoma constitutes only 1 - 7% of all testicular neoplasms and less than 1% of all non Hodgkin lymphoma. The authors report a new case of primary testicular lymphoma and highlight its diagnostic and therapeutic challenge. We report the case of a 26-year old man without a particular past medical history, who presented with a painful right testicular swelling that he has noticed for several weeks. Radiological findings consisted in multiple hypoechoic masses that corresponded in histological examination to a diffuse intratubular lymphomatous infiltration situated away from the spermatic cord, the epididymis, ductuli efferentes and rete testis. Immunohistochemical study showed positivity for leukocytic common antigen (CD45), B-cell marker (CD20) and bcl 6. The patient underwent full staging for lymphoma showing no evidence of extra-testicular involvement by lymphoma and no lymph nodes. The diagnosis of stage I primary testicular large B-cell lymphoma of germinal center B-cell-like group was made. The patient is now treated by chemotherapy. Primary testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non consensual etiological or predisposing factors. Treatment modalities consist in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized. Factors that have been linked to more favorable outcomes include younger patient age, localized disease, presence of sclerosis at pathologic analysis, smaller tumour size, lower histological tumor grade and lack of epididymal or spermatic cord involvement. KEYWORDS: Testicular lymphoma; Germinal center; B-cell.

[Paraganglioma of urinary bladder: report of two cases]. / Le paragangliome vesical: a propos de deux observations.

BACKGROUND: Extra-adrenal pheochromocytoma is a rare entity. Its occurrence in the urinary bladder has only been reported less than 200 times. AIM: Report 2 news cases CASES REPORT: Here we present two case reports of bladder paraganlioma with an update of the diagnostic techniques, treatment modalities and follow-up of patients with this disease. The common presentation of paraganglioma of the urinary bladder is painless haematuria, headache, palpitation and anxiety. Treatment of this lesion requires the same preparation as for any other site of pheochromocytoma. Partial cystectomy ensures radical and effective treatment. Long-term surveillance is necessary as recurrences or metastases have been described 20 and 40 years after treatment.

Lymphoepithelioma-like carcinoma of the skin in a tunisian patient.

Lymphoepithelioma-like carcinoma of the skin (LELCs) is a rare cutaneous neoplasm with histologic features resembling lymphoepitheliomatous tumors of the nasopharynx. The association of lymphoepitheliomas with Epstein-Barr Virus (EBV) at some extracutaneous sites is well documented. In contrast, the presence of EBV in LELCs has never been shown in either Caucasians or Asian patients. We present the first case of LELCs in a Tunisian patient, a 78-year-old woman who presented with a nodule of the right cheek of 2 months' duration. The patient underwent surgical excision and there was no evidence of local recurrence 6 months later. Histologically, the entire dermis was occupied by lobules composed of atypical epithelial cells surrounded by a dense lymphoplasmacytic infiltrate. Immunohistochemical examination showed that the epithelial tumor cells were positive for cytokeratin and epithelial membrane antigen. In situ hybridization investigations for the presence of EBV-encoded RNA showed negative results. Our findings suggest that LELCs is not related to EBV among North African patients.

[Multiple lymphomatous polyposis of the gastrointestinal tract: a Tunisian case]. / Polypose lymphomateuse multiple du tube digestif: un cas Tunisien.

Multiple lymphomatous polyposis is a distinctive primary gastrointestinal lymphoma which endoscopical, histopathological et immunophenotypical characteristics are well known. This lymphoma is rare and its prognosis is bad because of frequency of stage IV patients. We report the case of a 75-year-old male patient with multiple lymphomatous polyposis affecting the rectum, the colon and the stomach associated with an involvement of lymphadenopathies, bone marrow and liver. Treatment by chemotherapy was ineffective and patient dead after 3 sessions of CEOP protocol.