A case of extramedullary plasmacytoma of the testis diagnosed cytologically by scrotocentesis

A case of extramedullary plasmacytoma of the testis in an 82-year-old male is presented. Scrotocentesis allowed a cytological diagnosis to be made before orchiectomy. Preoperative examination revealed a high level of serum IgG, which normalized rapidly after surgical resection. Immunocytochemical and immunohistochemical studies demonstrated a monoclonal plasmacytic proliferation producing IgG with λ light chain. Whether the testicular nodule was primary or metastatic from another site remains an important question, but neither post-operative recurrence of multiple myeloma nor plasmacytoma of any other site has occurred in the more than 2 years since the initial diagnosis, pointing to a primary testicular plasmacytoma. Though extramedullary testicular plasmacytoma is very rare, careful cytoscreening will greatly facilitate accurate diagnosis.