You are here: Urology Textbook > Testes > Testicular lymphoma

Testicular Lymphoma: Diagnosis and Classification

Definition of Testicular Lymphoma

Lymphoma of the testis may represent the primary manifestation of extranodal disease or a secondary manifestation of disseminated lymphoma.

Epidemiology

5% of all testicular tumors, lymphoma is the most common testicular tumor in men over 50 years.

Pathology of Testicular Lymphoma

Gross anatomy: diffuse enlarged testicles. Microscopy: all known forms of lymphoma may be possible.

Ann Arbor Classification of Lymphoma:

Stage I:

Manifestation in a single lymph node region or a single extranodal organ (=I_E).

Stage II:

Manifestation in several lymph node regions or organ regions on one side of the diaphragm.

Stage III:

Manifestation in several lymph node regions or organ regions on both sides of the diaphragm.

Stage IV:

Disseminated manifestation in visceral organs.

Signs and Symptoms

• Testicular enlargement
• A quarter of patients report general symptoms such as weight loss, night sweats and weakness (B symptoms, the Letter B is added to the tumor stage in Ann Arbor classification).

Diagnosis of Testicular Lymphoma

Laboratory tests:

Differential blood count, erythrocyte sedimentation rate, LDH, testicular tumor markers (HCG, AFP).

Tumor Staging:

If histology of the testis reveals lymphoma, the following tests are indicated: bone marrow biopsy, bone scan, CT of the abdomen and chest.

Treatment of Testicular Lymphoma

Radical orchiectomy is often the initial step in the diagnosis and treatment of localized lymphoma. After that, experts in hematology and oncology perform appropriate staging and systemic lymphoma therapy. In patients with advanced lymphoma, histological confirmation of testicular lesions is not mandatory. Biopsy or orchiectomy is only necessary in unclear cases after chemotherapy.

References

  Deutsche Version: Lymphom des Hodens