Leukemia (testicular manifestations)

Last revised by Rohit Sharma on 20 Jun 2024

Leukemia testicular manifestations, or testicular leukemia, can be seen in patients during and after acute leukemia. The blood-testis barrier limits chemotherapy from reaching the testis, and therefore the testis can act as a sanctuary for leukemic cells.

Patients typically present with painless testicular enlargement, most commonly 2-3 years following primary disease diagnosis but recurrence has been reported up to 19 years post initial diagnosis 3.

Ultrasound appearance is often similar to testicular lymphoma, but it can have a very wide range of appearances:

  • testicular enlargement

  • unilateral or bilateral

  • focal or diffuse

  • hypoechoic to hyperechoic

Given the non-specific imaging features, an accurate clinical history is mandatory in order to make the correct diagnosis.

Cases and figures

  • Case 1: congenital AML relapse

Imaging differential diagnosis

  • Testicular seminoma
  • Testicular lymphoma - secondary involvement
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