testicular lymphoma
Testicular lymphoma is an uncommon testicular malignancy. Lymphoma can involve the testes in three ways:
- 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.
Epidemiology
Testicular lymphoma accounts for ~10% of testicular malignancies and ~2% of non-Hodgkin lymphomas . It is the most common bilateral intratesticular tumor.
It is the most common testicular tumor in men over the age of 60 years .
Clinical presentation
Unilateral testicular swelling or mass is the most common presentation, although the bilateral presentation is common (40%) .
Systemic symptoms such as weight loss, fever, and weakness may be present.
Pathology
Diffuse large B-cell lymphoma (DLBCL) accounts for the majority (~80%) of cases. Extranodal involvement is common, especially :
- Waldeyer ring
- skin and subcutaneous tissues
- central nervous system
- contralateral testis
- lung
Radiographic features
Ultrasound
Ultrasound features are non-specific :
- 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% .
Differential diagnosis
For ultrasound appearances consider :
- other primary testicular malignancies
- testicular hematoma
- testicular torsion
- epidydimo-orchitis and orchitis (overlapping ultrasound features, distinction often clinical)
- testicular leukemia (similar ultrasound appearance)
- testicular metastases (rare)
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Lymphom des Hodens:
