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- 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.
Testicular lymphoma accounts for ~10% of testicular malignancies and ~2% of non-Hodgkin lymphomas 1. It is the most common bilateral intratesticular tumor.
It is the most common testicular tumor in men over the age of 60 years 3.
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.
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
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
- color 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.
For ultrasound appearances consider 4:
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- 2. Cheah C, Wirth A, Seymour J. Primary Testicular Lymphoma. Blood. 2014;123(4):486-93. doi:10.1182/blood-2013-10-530659 - Pubmed
- 3. Sommers D & Winter T. Ultrasonography Evaluation of Scrotal Masses. Radiol Clin North Am. 2014;52(6):1265-81. doi:10.1016/j.rcl.2014.07.014 - Pubmed
- 4. Goodman J, Carr L, Ostrovsky P, Sunshine R, Yeh H, Cohen E. Testicular Lymphoma: Sonographic Findings. Urol Radiol. 1985;7(1):25-7. doi:10.1007/bf02926844 - Pubmed
- 5. Vural F, Cagirgan S, Saydam G, Hekimgil M, Soyer N, Tombuloglu M. Primary Testicular Lymphoma. J Natl Med Assoc. 2007;99(11):1277-82. PMC2574328 - Pubmed
- 6. Lokesh K, Sathyanarayanan V, Kuntegowdanahalli C, Suresh T, Dasappa L, Kanakasetty G. Primary Diffuse Large B-Cell Lymphoma of Testis: A Single Centre Experience and Review of Literature. Urol Ann. 2014;6(3):231-4. doi:10.4103/0974-7796.134277 - Pubmed