International Journal of Hematology

, Volume 97, Issue 2, pp 240–245 | Cite as

Primary testicular lymphoma: experience with 13 cases and literature review

Original Article

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

Alpha-fetoprotein

β-HCG

β-Human chorionic gonadotropin

CNS

Central nervous system

CT

Computed tomography

CR

Complete remission

DLBCL

Diffuse large B-cell lymphoma

DICE

Dexamethasone, ifosfamide, cisplatin, and etoposide

ESHAP

Etoposide, solumedrol (methylprednisolone), ara-C (high-dose cytarabine), and cisplatin

IPI

International Prognostic Index

MRI

Magnetic resonance imaging

NHL

Non-Hodgkin’s lymphoma

OS

Overall survival

PFS

Progression-free survival

PTL

Primary testicular lymphoma

Notes

Acknowledgments

The authors were supported by a Grant (WC) from the National Natural Science Foundation of China (81000817).

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

12185_2013_1261_MOESM1_ESM.doc (74 kb)
Supplementary material 1 (DOC 74 kb)

References

  1. 1.
    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.PubMedCrossRefGoogle Scholar
  2. 2.
    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.PubMedGoogle Scholar
  3. 3.
    Doll DC, Weiss RB. Malignant lymphoma of the testis. Am J Med. 1986;81:515–24.PubMedCrossRefGoogle Scholar
  4. 4.
    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.PubMedCrossRefGoogle Scholar
  5. 5.
    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.PubMedCrossRefGoogle Scholar
  6. 6.
    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.PubMedCrossRefGoogle Scholar
  7. 7.
    Vural F, Cagirgan S, Saydam G, Hekimgil M, Soyer NA, Tombuloglu M. Primary testicular lymphoma. J Natl Med Assoc. 2007;99:1277–82.PubMedGoogle Scholar
  8. 8.
    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.PubMedCrossRefGoogle Scholar
  9. 9.
    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.PubMedCrossRefGoogle Scholar
  10. 10.
    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.PubMedCrossRefGoogle Scholar
  11. 11.
    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.PubMedGoogle Scholar
  12. 12.
    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.PubMedCrossRefGoogle Scholar
  13. 13.
    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.PubMedCrossRefGoogle Scholar
  14. 14.
    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.PubMedCrossRefGoogle Scholar
  15. 15.
    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.PubMedCrossRefGoogle Scholar
  16. 16.
    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.PubMedGoogle Scholar
  17. 17.
    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.PubMedGoogle Scholar
  18. 18.
    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.CrossRefGoogle Scholar
  19. 19.
    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.Google Scholar
  20. 20.
    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.PubMedCrossRefGoogle Scholar
  21. 21.
    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.PubMedCrossRefGoogle Scholar
  22. 22.
    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.PubMedCrossRefGoogle Scholar
  23. 23.
    Darby S, Hancock BW. Localised non-Hodgkin lymphoma of the testis: the Sheffield Lymphoma Group experience. Int J Oncol. 2005;26:1093–9.PubMedGoogle Scholar
  24. 24.
    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.PubMedCrossRefGoogle Scholar
  25. 25.
    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.PubMedCrossRefGoogle Scholar
  26. 26.
    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.PubMedCrossRefGoogle Scholar
  27. 27.
    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.PubMedCrossRefGoogle Scholar
  28. 28.
    Singh LJ, Devi SB, Singh TA. Primary testicular lymphoma—a case report. J Indian Med Assoc. 2006;104:196–7.PubMedGoogle Scholar
  29. 29.
    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.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2013

Authors and Affiliations

  • Chu Wang
    • 1
  • Hai Wang
    • 1
  • Qinghai Wang
    • 1
  • Bingbing Shi
    • 1
  1. 1.Department of Urology, Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC)BeijingChina

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