RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 7: Male 68 – left scrotal mass
• MICROSCOPIC
• There is atrophic testis with sclerosed tubules, rete testis and paratesticular soft tissue with an
infiltrate which consist predominantly of atypical lymphoid cells s and also includes occasional
eosinophils. Within the soft tissue the infiltrate is associated d with fat necrosis and vessels with
prominent endothelial cells. The cells appear to be of medium size s
and in many cells the nuclei
appear slightly convoluted.
• Comment: The infiltrate appears to be composed of atypical lymphoid cells s consistent with a
lymphoma. The occasional eosinophils, the nuclear morphology and d the prominent endothelial
cells raise the possibility a T-cell T
lymphoma however flow cytometry and immunohistochemistry is
required for further categorisation.
• Investigations
• Check past history of patient
• Check to see if tissue was sent for flow cytometry.
• Immunoperoxidase stains; CD20, CD79a for B linage, CD3, CD43 for T linage also Bcl2, BcL6,
CD5, CD10, CD30. If just CD43 positive also do MPO to assess for myeloid linage.
• SUMMARY
• Testis and paratesticular tissue: Non-Hodgkin's lymphoma; subclassification based on flow
cytometry and immunoperoxidase results