Primary testicular lymphoma: experience with 13 cases and literature review
First Online: 25 January 2013 Received: 19 October 2012 Revised: 18 December 2012 Accepted: 27 December 2012 DOI:
Cite this article as: Wang, C., Wang, H., Wang, Q. et al. Int J Hematol (2013) 97: 240. doi:10.1007/s12185-013-1261-8 Abstract
To summarize the clinicopathological features, therapeutic regimens, and outcomes for patients with primary testicular lymphoma (PTL), we retrospectively reviewed the medical records of 13 patients diagnosed with PTL between 2001 and 2012 at our hospital. Average age at diagnosis was 62.2 ± 13.9 years, and all patients presented with painless testicular swelling. Diffuse large B-cell lymphoma was the dominant histotype (69.2 %). All 13 patients were treated with inguinal orchiectomy and received chemotherapy and/or radiotherapy. Complete follow-up data were available for 10 patients with an average follow-up duration of 28.4 ± 30.9 months. Seven patients were evaluated as Ann Arbor stage I or II, and three as stage III or IV. Eight patients were found to have hypoechogenic and hypervascular signals in the testis on ultrasound examination. Complete remission was achieved in six patients, and four patients who were still undergoing chemotherapy during the last follow-up showed no signs of relapse. Of the 10 patients with complete follow-up records, three had relapses, which occurred in the CNS, epiglottis, and the nasal cavity. Time to relapse in these cases was 2, 7, and 11 months, respectively (3/10). The mean progression-free survival was 22.57 months (range 1.1–101.9 months).
Keywords Primary testicular lymphoma Large B-cell lymphoma Testicular hydrocele Treatment Patient outcomes Abbreviations AFP
β-Human chorionic gonadotropin
Central nervous system
Diffuse large B-cell lymphoma
Dexamethasone, ifosfamide, cisplatin, and etoposide
Etoposide, solumedrol (methylprednisolone), ara-C (high-dose cytarabine), and cisplatin
International Prognostic Index
Magnetic resonance imaging
Primary testicular lymphoma
Electronic supplementary material
The online version of this article (doi:
) contains supplementary material, which is available to authorized users. 10.1007/s12185-013-1261-8 References
Fonseca R, Habermann TM, Colgan JP, O’Neill BP, White WL, Witzig TE, et al. Testicular lymphoma is associated with a high incidence of extranodal recurrence. Cancer. 2000;88:154–61.
Balogun TM, Omodele FO, Olaiya MA. Primary lymphoma of the testis in remission for more than ten years: a case report. West Afr J Med. 2009;28:388–90.
Doll DC, Weiss RB. Malignant lymphoma of the testis. Am J Med. 1986;81:515–24.
Hurley LJ, Burke CR, Shetty SK, Previte SR, Sakr OE, Libertino JA. Bilateral primary non-Hodgkin’s lymphoma of the testis. Urology. 1996;47:596–8.
Lagrange JL, Ramaioli A, Theodore CH, Terrier-Lacombe MJ, Beckendorf V, Biron P, et al. Non-Hodgkin’s lymphoma of the testis: a retrospective study of 84 patients treated in the French anticancer centres. Ann Oncol. 2001;12:1313–9.
Park BB, Kim JG, Sohn SK, Kang HJ, Lee SS, Eom HS, et al. Consideration of aggressive therapeutic strategies for primary testicular lymphoma. Am J Hematol. 2007;82:840–5.
Vural F, Cagirgan S, Saydam G, Hekimgil M, Soyer NA, Tombuloglu M. Primary testicular lymphoma. J Natl Med Assoc. 2007;99:1277–82.
Conrad AL, Go RS. Contralateral testicular relapse after prophylactic radiation in a patient with primary testicular diffuse large B-cell lymphoma. Eur J Haematol. 2009;83:603–5.
Geetha N, Jayasree K, Ittiyavirah AK, Lali VS, Nair MK. Renal relapse in bilateral synchronous testicular lymphoma. Am J Clin Oncol. 2000;23:290–1.
Sasai K, Yamabe H, Tsutsui K, Dodo Y, Ishigaki T, Shibamoto Y, et al. Primary testicular non-Hodgkin’s lymphoma: a clinical study and review of the literature. Am J Clin Oncol. 1997;20:59–62.
Autorino R, Lamendola MG, De Sio M, Di Trolio RA, Ferraraccio F, Di Lorenzo G. A complete response with rituximab in metastatic diffuse large B-cell lymphoma of the testis: case report. Int J Immunopathol Pharmacol. 2007;20:401–3.
Langar S, Sharma PK, Bhardwaj M, Kar HK. Cutaneous relapse of primary testicular non-Hodgkin lymphoma-the first sign of disease dissemination. Indian J Dermatol Venereol Leprol. 2010;76:576–8.
Avilés A, Neri N, Huerta-Guzmán J, Pérez F, Fernández R. Testicular lymphoma: organ-specific treatment did not improve outcome. Oncology. 2004;67:211–4.
Ornstein DL, Bifulco CB, Braddock DT, Howe JG. Histopathologic and molecular aspects of CD56 + natural killer/T-cell lymphoma of the testis. Int J Surg Pathol. 2008;16:291–300.
Kim YB, Chang SK, Yang WI, Hahn JS, Koom WS, Shim SJ, et al. Primary NK/T cell lymphoma of the testis. A case report and review of the literature. Acta Haematol. 2003;109:95–100.
Touroutoglou N, Dimopoulos MA, Younes A, Hess M, Pugh W, Cox J, et al. Testicular lymphoma: late relapses and poor outcome despite doxorubicin-based therapy. J Clin Oncol. 1995;13:1361–7.
Ostronoff M, Soussain C, Zambon E, Moran A, Droz JP, Bosq J, et al. Localized stage non-Hodgkin’s lymphoma of the testis: a retrospective study of 16 cases. Nouv Rev Fr Hematol. 1995;37:267–72.
The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329:987–94.
Vara Castrodeza A, Torres Nieto A, Mendo González M, Rodríguez Toves A, Peñarrubia Ponce MJ, de la Fuente Bobillo MA. Diagnosis of a primary testicular lymphoma by echography and magnetic resonance imaging. Clin Transl Oncol. 2006;8:456–8.
Li D, Xie P, Mi C. Primary testicular diffuse large B-cell lymphoma shows an activated B-cell-like phenotype. Pathol Res Pract. 2010;206:611–5.
Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103:275–82.
Al-Abbadi MA, Hattab EM, Tarawneh MS, Amr SS, Orazi A, Ulbright TM. Primary testicular diffuse large B-cell lymphoma belongs to the nongerminal center B-cell-like subgroup: a study of 18 cases. Mod Pathol. 2006;19:1521–7.
Darby S, Hancock BW. Localised non-Hodgkin lymphoma of the testis: the Sheffield Lymphoma Group experience. Int J Oncol. 2005;26:1093–9.
Zucca E, Conconi A, Mughal TI, Sarris AH, Seymour JF, Vitolo U, et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol. 2003;21:20–7.
Davis JW, Moriarty RP, Schlossberg SM, Schellhammer PF. Bilateral testicular lymphoma treated with chemotherapy and radiation without orchiectomy: complete response relapsed at 52 months in the vitreous humor. Urology. 2001;57:555.
Zouhair A, Weber D, Belkacemi Y, Ketterer N, Dietrich PY, Villà S, et al. Outcome and patterns of failure in testicular lymphoma: a multicenter Rare Cancer Network study. Int J Radiat Oncol Biol Phys. 2002;52:652–6.
Moller MB, d’Amore F, Christensen BE. Testicular lymphoma: a population-based study of incidence, clinicopathological correlations and prognosis. The Danish Lymphoma Study Group, LYFO. Eur J Cancer. 1994;30A:1760–4.
Singh LJ, Devi SB, Singh TA. Primary testicular lymphoma—a case report. J Indian Med Assoc. 2006;104:196–7.
Aliferis K, Chan CC, Donati G, Baglivo E. Intraocular lymphoma following a primary testicular lymphoma in remission for 10 years. Int Ophthalmol. 2008;28:439–40.
PubMed CrossRef Copyright information
© The Japanese Society of Hematology 2013