Intravascular cytotoxic T-cell lymphoma presenting as hydrocele testis: a case report and review of the literature

Intravascular lymphoma (IVL) is a rare entity of extranodal large cell lymphoma. Most cases of IVL are B-cell phenotype, with a few cases of T-cell or NK-cell origin. To our knowledge, only 5 cases of intravascular cytotoxic T-cell lymphoma with sufficient phenotype studies have been reported so far. Here, a case of intravascular cytotoxic T-cell lymphoma initially occurred in epididymis in a 67-year-old male presenting as hydrocele testis was studied to define the clinicopathologic aspects of the rare disease. The lymphoma was studied by standard H.E staining, immunohistochemistry, in situ hybridization, as well as molecular assay for T cell receptor (TCR) rearrangement. Histological exam of epididymis revealed IVL with cytotoxic T-cell phenotype. The neoplastic cells were CD45+, CD3+, Granzyme B+, TIA-1+, CD56-, CD20-, CD79a-, CD30-, and the neoplastic cells were also positive for EpsteinBarr virus-encoded RNA (EBER) by in situ hybridization technique. Moreover, molecular study revealed monoclonal rearrangement for T-cell receptor (TCR). The finding in the present case may address the unique clinicopathologic features of the EBV-associated IVL.