精索腫瘍にて発見された悪性リンパ腫

Spermatic cord tumor as a manifestation of malignant lymphoma

　症例は54歳，男性。有痛性右鼠径部腫瘤を主訴に当院を受診した。骨盤部MRIでは右精索部に強い造影効果を示す腫瘤を認めた。胸腹部CTでは傍大動脈領域に巨大な腫瘤を認め，盲腸・肺にも腫瘤を認めた。右高位精巣摘除術を施行した。病理組織学的には，悪性リンパ腫，diffuse large B-cell typeであった。精索の節外性病変が初発症状となった悪性リンパ腫の本邦報告例は，本症例が3例目であった。

A 54-year-old man presented with a complaint of painful firm groin mass. In the blood examination, high levels of serum soluble interleukin 2 receptor were detected. Radiological examinations showed groin tumor along the right spermatic cord, a bulky tumor around the para-aortic region, and multiple coin lesions in both lungs. He underwent right high inguinal orchiectomy. Histological examination demonstrated a malignant lymphoma of the spermatic cord（B-cell, diffuse large cell type）. Finally, he was diagnosed as metastatic spermatic cord tumor of malignant lymphoma. Despite the meticulous chemotherapy, he died of progression of the disease 6 months after the orchiectomy.