Clinical analysis of 26 patients with testicular lymphoma

Objective: Malignant testicular lymphoma was rare in clinic. This study is to summarize the clinical features, diagnosis, treatment, and prognosis of testicular lymphoma. Methods: Twenty-six malignant testicular lymphoma patients were treated during the period between 1980 and 2007. The patients included 22 cases of primary testicular lymphoma (84.6%) and 4 cases of secondary testicular lymphoma (15.4%) confirmed by histopathological examination. All the patients received testectomy. Nineteen patients with primary testicular lymphoma were followed up. Out of the 19 cases, 3 cases received surgery only, 14 cases received chemotherapy and surgery, and 2 cases received surgery combined with radiotherapy and chemotherapy. All of the primary primary 4 cases with secondary testicular lymphoma received whole body chemotherapy and local radiotherapy. Results: All of the primary patients, with a median age of 57 years, initially presented a painless testicular enlargement. The most common pathological type was diffuse large B-cell lymphoma (DLBCL) (84.6%, 22/ 26). Less common types included extranodal NK/T cell lymphoma, lymphoblastic lymphoma, and unclassifiable B-cell lymphoma. The 5-year overall survival rate of primary testicular lymphoma patients was 72%. The median survival time of the patients was 95.8 months for those at I/ II Ann-Arbor staging and 21.5 months for those at III/IV Ann-Arbor staging, respectively. The median survival time without relapse was 78.8 months and the median survival time was 92.3 months for the patients who were treated with combined surgery and chemotherapy. The median survival time without relapse was 7.5 months and overall survival time was 25 months for the patients with the secondary testicular lymphoma. Conclusion: Testicular lymphomas predominantly occurred in elderly males. The prognosis may be related with clinical staging, pathological classification, and therapeutic regimens. The work recommended adjuvant radiotherapy and four to six cycles of CHOP/CHOP-like chemotherapy in addition to surgery for all the patients.