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ABSTRACT: Primary testicular lymphoma (PTL) is an uncommon neoplasm (<5% of all testicular tumors). Testicular lymphoma presents with homogeneous mass, hyperintense on T1-weighted images, and iso-to-hypointense on T2-weighted images with strong diffusion restriction and homogeneous contrast enhancement. Seminoma testis, a close differential due to T2 hypointensity and homogeneousity, can be differentiated by its lower diffusion restriction and younger age group. Involvement of spermatic cord and epididymis is rare with seminoma. Intra-abdominal extension along the gonadal vein is not reported. PTL disseminates to extranodal sites. However, extension of PTL along the spermatic cord and gonadal vein up to the inferior vena cava is a rare phenomenon. We report 2 cases of PTL with involvement of epididymis and spermatic cord and further continuous extension along the gonadal vein up to the inferior vena cava. These findings are very rare and when present may help to differentiate testicular lymphoma from other testicular tumors.
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ABSTRACT: We report a case of a young man who had a new onset S wave in lead 1 in his ECG with typical symptoms of acute onset of dyspoena 2 months after an episode of deep vein thrombosis, S wave disappeared 6 days after thrombolysis. We report this case as the clinical course was very typical plus we have reviewed the literature regarding diagnosis and risk stratification of pulmonary embolism for the student, or the casualty medical officer.
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