A 32-year-old man presented with a nontender right testicular mass. A testicular sonogram revealed a solid mass but alphafetoprotein and beta-human chorionic gonadotropin were negative. A right radical orchiectomy was performed (Fig. 58.1). Four cycles of chemotherapy were administered in conjunction with intrathecal methotrexate with resultant pancytopenia. The patient subsequently developed B symptoms (fever, night sweats, and weight loss) and CT scan demonstrated splenomegaly. A splenectomy (Fig. 58.2) and liver biopsy (Fig. 58.3) were performed. After splenectomy, pancytopenia resolved, but he suddenly developed leukocytosis (40, 000/μl). Neoplastic lymphoid cells were found in the peripheral blood (Fig. 58.4) and the bone marrow (Figs.58.5 and 58.6). The patient died of massive gastrointestinal hemorrhage six months after the initial diagnosis.
KeywordsNatural Killer Cell Large Granular Lymphocyte Hematologic Neoplasm Nasal Type Blastic Plasmacytoid Dendritic Cell Neoplasm
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