Testicular lymphoma
Updates to Article Attributes
Testicular lymphoma is an uncommon testicular malignancy. Lymphoma can involve the testes in three ways:
- primary site of extranodal disease (primary testicular lymphoma)
- secondary involvement of systemic disease
- primary manifestation of subclinical systemic disease
This article is concerned with primary testicular lymphoma.
Epidemiology
Testicular lymphoma accounts for ~10% of testicular malignancies and ~2% of non-Hodgkin lymphomas 1. It is the most common bilateral intratesticular tumour.
It is the most common testicular tumour in men over the age of 60 years 3.
Clinical presentation
Unilateral testicular swelling or mass is the most common presentation, although the bilateral presentation is common (40%) 1,3.
Systemic symptoms such as weight loss, fever, and weakness may be present.
Pathology
Diffuse large B-cell lymphoma (DLBCL) accounts for the majority (~80%) of cases. Extranodal involvement is common, especially 3,4:
- Waldeyer ring
- skin and subcutaneous tissues
- central nervous system
- contralateral testis
- lung
Radiographic features
Ultrasound
Ultrasound features are non-specific 4:
- diffuse enlargement with ill-defined hypoechoic signal
- discrete hypoechoic intratesticular mass(es)
- epididymis may be enlarged and hypoechoic as well
- colour Doppler: testis is markedly hypervascular
Treatment and prognosis
Orchiectomy and systemic chemotherapy is preferred treatment due to distant sites of relapses. The 10-year survival is reported at 88% with a relapse rate of 8% 5,6.
Differential diagnosis
For ultrasound appearances consider 4:
- other primary testicular malignancies
- testicular haematoma
- testicular torsion
- epidydimo-orchitis and orchitis (overlapping ultrasound features, distinction often clinical)
- testicular leukaemia (similar ultrasound appearance)
- testicular metastases (rare)
-<li><a title="Testicular cancer" href="/articles/testicular-cancer">other primary testicular malignancies</a></li>- +<li><a href="/articles/testicular-cancer">other primary testicular malignancies</a></li>
Image 5 MRI (T2) ( create )
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