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Neurological symptoms induced by the infiltration of malignant lymphoma into the nervous systems are subsumed under the term neurolymphomatosis (NL). Here, we report the case of a 30-year-old Japanese man with primary testicular lymphoma complicated, as seen in various neurological findings, by secondary NL prior to testicular swelling. Painless right scrotal enlargement was noticed more than 1 month after the appearance of neurological complications such as right upper extremity numbness, dysarthria, facial palsy, and diplopia. Proactive investigation and biopsies of extranodal sites at high risk of central nervous system infiltration of malignant lymphoma, such as the testes, should be considered when secondary NL is suspected based on imaging findings.

Aflatoxin produced by Aspergillus flavus is known to be strongly related to liver injury (hepatocellular carcinoma)and immune system damage involving leukocytes. This toxin suppresses both the cell-mediated immune system and macrophage function, and decreases the production of complement and interferon molecules. Purpose: To evaluate the presence of aflatoxin in infectious lesions as well as how the toxin is taken up by leukocytes. Method: Pathological specimens from a patient who died from aspergillosis caused by aflatoxin-producing A. flavus were used. Anti-aflatoxin B1 antibody was reacted with paraffin-embedded lesion specimens from the heart, kidney, and thyroid gland of the patient and observed microscopically. Result: Positive reactions were detected in fungal elements and leukocytes (neutrophils and macrophages)in inflammatory lesions. Conclusion: Within the patient's body, A. flavus likely produced aflatoxin, which then was taken up by neutrophils and macrophages. These results suggest that leukocyte function and the immune mechanism are locally suppressed by aflatoxin. [ABSTRACT FROM AUTHOR]