Primary testicular lymphoma

Umberto Vitolo, Andrés J M Ferreri, Emanuele Zucca

Research output: Contribution to journalArticle

Abstract

Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9% of testicular neoplasms and 1-2% of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in primary forms; aggressive histologies, especially Burkitt's lymphoma, are prevalent in cases of secondary involvement of testis. The most common clinical presentation is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. Systemic B symptoms are present in 25-41% of patients with advanced stage. Less frequently, abdominal pain, and ascites can be seen in patients with involvement of retroperitoneal lymph nodes. Bilateral testicular involvement is detected in up to 35% of patients. Although good results with doxorubicin-containing chemotherapy, followed or not by radiotherapy, have been reported, a high proportion of patients with stage I-II diseases experience aggressive relapses, and patients with advanced disease have a very poor prognosis. PTL has a propensity to disseminate to other extranodal organs, including the controlateral testis, CNS, skin, Waldeyer's ring, lung, pleura, and soft tissue. Orchidectomy followed by R-CHOP combination, with CNS prophylaxis, and prophylactic irradiation of the contralateral testis is the recommended first-line treatment for patients with limited disease. Management of patients with advanced or relapsed disease should follow the worldwide recommendations for nodal DLBCL.

Original languageEnglish
Pages (from-to)183-189
Number of pages7
JournalCritical Reviews in Oncology/Hematology
Volume65
Issue number2
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Lymphoma
Testis
Lymphoma, Large B-Cell, Diffuse
Non-Hodgkin's Lymphoma
Orchitis
Filariasis
Cryptorchidism
Burkitt Lymphoma
Orchiectomy
Pleura
Testicular Neoplasms
Ascites
Doxorubicin
Abdominal Pain
Case-Control Studies
Histology
Radiotherapy
Lymph Nodes
Recurrence
Drug Therapy

Keywords

  • Central nervous system lymphoma
  • Diffuse large B-cell lymphoma
  • Testicular neoplasm
  • Waldeyer's ring

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Primary testicular lymphoma. / Vitolo, Umberto; Ferreri, Andrés J M; Zucca, Emanuele.

In: Critical Reviews in Oncology/Hematology, Vol. 65, No. 2, 02.2008, p. 183-189.

Research output: Contribution to journalArticle

Vitolo, Umberto ; Ferreri, Andrés J M ; Zucca, Emanuele. / Primary testicular lymphoma. In: Critical Reviews in Oncology/Hematology. 2008 ; Vol. 65, No. 2. pp. 183-189.
@article{3a9e1a5a6605411f9b8a9d82efc25408,
title = "Primary testicular lymphoma",
abstract = "Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9{\%} of testicular neoplasms and 1-2{\%} of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in primary forms; aggressive histologies, especially Burkitt's lymphoma, are prevalent in cases of secondary involvement of testis. The most common clinical presentation is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. Systemic B symptoms are present in 25-41{\%} of patients with advanced stage. Less frequently, abdominal pain, and ascites can be seen in patients with involvement of retroperitoneal lymph nodes. Bilateral testicular involvement is detected in up to 35{\%} of patients. Although good results with doxorubicin-containing chemotherapy, followed or not by radiotherapy, have been reported, a high proportion of patients with stage I-II diseases experience aggressive relapses, and patients with advanced disease have a very poor prognosis. PTL has a propensity to disseminate to other extranodal organs, including the controlateral testis, CNS, skin, Waldeyer's ring, lung, pleura, and soft tissue. Orchidectomy followed by R-CHOP combination, with CNS prophylaxis, and prophylactic irradiation of the contralateral testis is the recommended first-line treatment for patients with limited disease. Management of patients with advanced or relapsed disease should follow the worldwide recommendations for nodal DLBCL.",
keywords = "Central nervous system lymphoma, Diffuse large B-cell lymphoma, Testicular neoplasm, Waldeyer's ring",
author = "Umberto Vitolo and Ferreri, {Andr{\'e}s J M} and Emanuele Zucca",
year = "2008",
month = "2",
doi = "10.1016/j.critrevonc.2007.08.005",
language = "English",
volume = "65",
pages = "183--189",
journal = "Critical Reviews in Oncology/Hematology",
issn = "1040-8428",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Primary testicular lymphoma

AU - Vitolo, Umberto

AU - Ferreri, Andrés J M

AU - Zucca, Emanuele

PY - 2008/2

Y1 - 2008/2

N2 - Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9% of testicular neoplasms and 1-2% of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in primary forms; aggressive histologies, especially Burkitt's lymphoma, are prevalent in cases of secondary involvement of testis. The most common clinical presentation is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. Systemic B symptoms are present in 25-41% of patients with advanced stage. Less frequently, abdominal pain, and ascites can be seen in patients with involvement of retroperitoneal lymph nodes. Bilateral testicular involvement is detected in up to 35% of patients. Although good results with doxorubicin-containing chemotherapy, followed or not by radiotherapy, have been reported, a high proportion of patients with stage I-II diseases experience aggressive relapses, and patients with advanced disease have a very poor prognosis. PTL has a propensity to disseminate to other extranodal organs, including the controlateral testis, CNS, skin, Waldeyer's ring, lung, pleura, and soft tissue. Orchidectomy followed by R-CHOP combination, with CNS prophylaxis, and prophylactic irradiation of the contralateral testis is the recommended first-line treatment for patients with limited disease. Management of patients with advanced or relapsed disease should follow the worldwide recommendations for nodal DLBCL.

AB - Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9% of testicular neoplasms and 1-2% of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in primary forms; aggressive histologies, especially Burkitt's lymphoma, are prevalent in cases of secondary involvement of testis. The most common clinical presentation is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. Systemic B symptoms are present in 25-41% of patients with advanced stage. Less frequently, abdominal pain, and ascites can be seen in patients with involvement of retroperitoneal lymph nodes. Bilateral testicular involvement is detected in up to 35% of patients. Although good results with doxorubicin-containing chemotherapy, followed or not by radiotherapy, have been reported, a high proportion of patients with stage I-II diseases experience aggressive relapses, and patients with advanced disease have a very poor prognosis. PTL has a propensity to disseminate to other extranodal organs, including the controlateral testis, CNS, skin, Waldeyer's ring, lung, pleura, and soft tissue. Orchidectomy followed by R-CHOP combination, with CNS prophylaxis, and prophylactic irradiation of the contralateral testis is the recommended first-line treatment for patients with limited disease. Management of patients with advanced or relapsed disease should follow the worldwide recommendations for nodal DLBCL.

KW - Central nervous system lymphoma

KW - Diffuse large B-cell lymphoma

KW - Testicular neoplasm

KW - Waldeyer's ring

UR - http://www.scopus.com/inward/record.url?scp=37549067778&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37549067778&partnerID=8YFLogxK

U2 - 10.1016/j.critrevonc.2007.08.005

DO - 10.1016/j.critrevonc.2007.08.005

M3 - Article

C2 - 17962036

AN - SCOPUS:37549067778

VL - 65

SP - 183

EP - 189

JO - Critical Reviews in Oncology/Hematology

JF - Critical Reviews in Oncology/Hematology

SN - 1040-8428

IS - 2

ER -