# Secondary Acute Myeloid Leukemia in Treatment-Naïve Primary Testicular Diffuse Large B-Cell Lymphoma

## TL;DR

A man with untreated testicular lymphoma later developed a rare form of secondary leukemia, highlighting the need for careful monitoring and diagnosis.

## Contribution

Reports a rare case of secondary AML arising from an untreated primary testicular lymphoma.

## Key findings

- sAML developed in a patient with untreated primary testicular DLBCL five years after diagnosis.
- Immunophenotyping confirmed the monocytic subtype (AML-M5) of the secondary leukemia.
- The patient's death during bridging treatment underscores the severity of this clinical progression.

## Abstract

Secondary acute myeloid leukemia (sAML) typically arises from a prior myeloid malignancy or as a complication of cytotoxic therapy for other cancers. Rarely, it may develop without antecedent treatment, particularly in lymphoid malignancies. We report an unusual case of sAML in a treatment-naïve patient previously diagnosed with primary testicular diffuse large B-cell lymphoma (DLBCL). A 58-year-old male initially presented with Stage 1E primary testicular DLBCL and declined recommended treatment. Five years later, he developed symptoms and laboratory features of acute myeloid leukemia (AML), confirmed as monocytic subtype (M5) via immunophenotyping. Despite planned hypomethylating agent-based therapy, he succumbed during bridging treatment. This case highlights the diagnostic importance of immunophenotyping and an uncommon clinical trajectory from untreated lymphoid malignancy to sAML.