The association between human immunodeficiency virus HIV infection and the increased incidence of testicular tumors is a recent well-recognized phenomenon. Testicular tumors in the setting of HIV infection are most frequently of germ cell origin, less commonly lymphomas. We are presenting a unique case of testicular non-Hodgkin's B-cell lymphoma with associated atrial mass and mediastinal lymphadenopathy. The patient was not known to be HIV positive at the time of presentation. The initial clinical, radiological, and gross pathologic impression was that of seminoma. Discussion of the differential diagnosis and appropriate work up is presented.

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