A malignant fibroleiomyoma of the testis

The patient described has a 2-cm, hard, painless nodule close to an atrophic testis that had been present for > 10 years, suggesting inactive disease, recently associated with fever of undetermined origin with constitutional symptoms. Extensive examinations of pleural, spinal, and bronchoalveolar fluids; bacterial and mycobacterial cultures; bone biopsies; and computed tomography scans were inconclusive. Orchiectomy demonstrated an angiotropic large B-cell lymphoma (CD19+CD20+CD79a+) in the context of a benign fibroleiomyoma. The symptoms abated after the first of 4 rituximab injections. Reports suggest that benign tumors can be harbingers of angiotropic lymphoma or facilitate its onset. To date, no testicular or epididymal primary site has been reported for angiotropic lymphoma.