CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
This article is part of the Research TopicCase-based Advances in the Understanding of Rare and Unusual Hematologic Malignancies 2025View all 4 articles
Primary scrotal diffuse large B-cell lymphoma with skip metastasis to the mediastinum: A Case Report and Literature Review
Provisionally accepted
- Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Primary scrotal diffuse large B-cell lymphoma (PS-DLBCL) is an uncommon disease. Due to the scarcity of case reports, its atypical clinical manifestations often lead to misdiagnosis. An 81-year-old male patient presented with a rapidly enlarging, painless left scrotal mass. Imaging studies suggested sarcoma or seminoma. A chest computed tomography (CT) scan incidentally revealed mediastinal masses. Laboratory tests showed significantly elevated lactate dehydrogenase and β2-microglobulin levels. Postoperative histopathological examination confirmed DLBCL with a germinal center B-cell subtype, accompanied by an abnormally high Ki-67 proliferation index (>90%) and P53 translocation. FISH testing ruled out double-hit lymphoma. Notably, staging evaluation identified "isolated mediastinal involvement" without inguinal, pelvic, or retroperitoneal lymph node involvement, defining a "skip metastasis" pattern. The patient was diagnosed with stage IV disease and a high-risk International Prognostic Index (IPI) score of 5. Refusing chemotherapy, the patient died within three months of initial diagnosis due to rapid disease progression. This case highlights: Scrotal lymphoma is rare yet highly aggressive, with clinical presentations frequently confused with common malignancies. Diagnosis relies on biopsy and immunohistochemistry, requiring clinicians to remain vigilant for early detection and intervention.
Keywords: Primary scrotal diffuse large B-cell lymphoma (PS-DLBCL), Non-Hodgkin lymphoma (NHL), Skip metastasis, B-cell, case report
Received: 07 Sep 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Wang, Tang, Xiao, Li, Liang, Zhao and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Wu
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