PMC7234348_01
MRI shows the tumor in the right epididymis. The tumor is shown as a faint high-signal intensity on T2-weighted images ((a) axial image), ((b) coronal image), a high-signal intensity on diffusion-weighted images (c), and was also enhanced homogeneously (d). Abdominal CT at the time of recurrence shows the tumor located in the left sub-diaphragm (e) and para aorta (f).
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By magnetic resonance imaging (MRI), the mass was observed as a faint high-signal intensity on T2-weighted images, high-signal intensity on diffusion-weighted images, and was also enhanced homogeneously (Figure 1(a)-(d)). Six months after the operation, CT showed masses in the para-aortic and left sub-diaphragm (Figure 1(e) and (f)). However, cytogenetic analysis showed abnormal karyotype, 47XY, add(2)(p13), del(6)(q21q25), add(8)(p11.2), +21, in 13 of 20 metaphases examined (Supplemental Figure 1).
Pathological findings. Malignant cells proliferated invasively toward seminiferous tubules. They were shown to have monotonous structures, high nuclear-to-chromatin ratios, prominent nucleoli, scant cytoplasm, and fine chromatin. (Haematoxylin & eosin sections: (a) x5; (b) x20). By immunohistochemistry, the epididymis specimen was strongly positive for c-kit, CD43, CD34, CD45, and CD7l; however, it was weakly positive for CD68 and negative for MPO. The specimen from the epididymis and recurrent tumor showed similar characteristics except for MPO and CD68 stainings ((c)-(p) x10).
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B-cells (CD10, CD20, PAX5, and MUM1) were negative (Figure 2). The specimen had similar histopathological characteristics as those in the epididymal tumor (Figure 2).