ABSTRACT
Primary testicular non-Hodgkin’s lymphoma (NHL) is a rare, clinically aggressive form of extranodal lymphoma and constitutes 1% of all NHL and 5% of all testicular neoplasms. The vast majority of primary testicular lymphomas (PTLs) are diffuse large B-cell lymphoma (DLBCL); however, Burkitt’s lymphoma, anaplastic lymphoma, or Hodgkin’s lymphoma may primarily involve the testis but it is less common. High inguinal orchiectomy, along with chemotherapy with or without radiotherapy, is the current treatment of choice for these tumors. Here, we present the case of primary testicular NHL in a 72-year-old male.
ABSTRACT
Primary testicular lymphoma (PTL) is an uncommon extranodal presentation constituting 1% of all NHL and 5% of all testicular neoplasm. The objective of our study was to identify the presenting signs and symptoms, treatment and outcome of patients with testicular lymphoma diagnosed at the Hematology department of Farhat Hached University Hospital from 1997 to 2007 and to perform bibliography review about this pathology. Eleven cases were identified; the median age was 61 years (range:31-83). All patients presented with testicular and scrotal swelling or mass. B symptoms (recurrent fever of>38ºC temperature, night sweets and unexplained weight loss of>10% of the body weight within six months prior to diagnosis) were present in 6 patients. According to the "Ann-Arbor staging system", 7 patients were classified stage IE( involving a single lymph node region (I) or single extralymphatic organ or site) and IIE (two or more involved lymph node regions on the same side of the diaphragm (II) or localized involvement of an extralymphatic organ or site), 4 patients were classified stage IVE (the presence of diffuse or disseminated involvement of one or more extralymphatic organs (e.g., liver, bone, marrow, lung), with or without associated lymph node involvement). International Prognostic index was low (<2) in 7 patients and high (≥2) in 4 cases. Orchidectomy was performed in all cases. Eight patients received chemotherapy based on COP (2cases), mini CEOP (3 cases), ACVBP (2 cases). Eight patients received central nervous system prophylaxis in the form of intrathecal methotrexate. Radiation at the dose of 40Gy was given to 3 patients. Three patients achieved complete remission. Two patients relapsed. The median survival was 3 months (range: 1 week-107 months). Testicular lymphoma is a rare and deadly form of extra nodal lymphoma, randomized prospective treatment trials may help to establish better treatment strategies.
ABSTRACT
Primary testicular lymphomas (PTL) are rare entities representing 1-2% of Non-Hodgkin's Lymphoma (NHL) and 1-7% of malignant testicular tumours. They are most commonly seen in men older than 60 years. The most common type of primary testicular lymphoma (PTL) is diffuse large B-cell type which has the potential for aggressive clinical behaviour. We report the case of a 45 years old male with primary testicular lymphoma which was first diagnosed on Fine Needle Aspiration Cytology (FNAC) and subsequently confirmed histopathologically and immunophenotypically as Diffuse Large B-Cell Lymphoma (DLBCL) showing CD20 positivity. This case report confirms the literature data concerning the rarity of testicular Non Hodgkin's Lymphoma (TNHL) with DLBCL being the most common phenotype and the poor prognosis of the disease despite aggressive management.
ABSTRACT
Primary testicular lymphoma (PTL) is an uncommon extranodal lymphoma,with an aggressive clinical course and poor outcome.A combined treatment with full-course anthracycline-based chemotherapy with rituximab and central nervous system prophylaxis with intrathechal methotrexate and contralateral testicular radiotherapy should be considered as the standard of care at limited stage.These patients have a very high risk of central nervous system recurrence and the addition of systemic central nervous system prophylaxis with intravenous methotrexate may be the best treatment option.Primary central nervous system lymphoma (PCNSL) is an aggressive disease with a dismal prognosis,particularly when treated with established protocols used for systemic non-Hodgkin lymphoma.Use of methotrexate in combination with cytarabine has been proposed as a standard induction regimen.The role of the anti-CD20 antibody has not yet been defined,however,phase Ⅰ and Ⅱ trials suggest its efficacy despite low penetration within the cerebrospinal fluid.High-dose chemotherapy followed by autologous stem cell transplantation has shown high remission rates with 3-year overall suvival rates of up to 87 ％.
ABSTRACT
BACKGROUND: Primary testicular diffuse large B-cell lymphoma (DLBCL) is a rare but aggressive extranodal lymphoma, and its relapse in the central nervous system (CNS) is a major concern during treatment. Despite this, the role of intrathecal prophylaxis in primary testicular DLBCL remains controversial. METHODS: We retrospectively reviewed the medical records of 14 patients with primary testicular DLBCL diagnosed between November 2000 and June 2012, and analyzed the CNS relapse rate in patients treated without intrathecal prophylaxis. Survival curves were estimated using the Kaplan-Meier method. RESULTS: The median age at diagnosis was 57 years (range, 41-79 years). Unilateral testicular involvement was observed in 13 patients. Nine patients had stage I, 1 had stage II, and 4 had stage IV disease. The international prognostic index was low or low-intermediate risk in 12 patients and high-intermediate risk in 2 patients. Thirteen patients underwent orchiectomy. All the patients received systemic chemotherapy without intrathecal prophylaxis, and prophylactic radiotherapy was administered to the contralateral testis in 12 patients. The median follow-up period of surviving patients was 39 months (range, 10-139 months). Median overall survival was not reached and the median progression-free survival was 3.8 years. Four patients experienced relapse, but CNS relapse was observed in only one patient (7.1%) with stage IV disease, 27 months after a complete response. CONCLUSION: Even without intrathecal prophylaxis, the rate of relapse in the CNS was lower in the Korean patients with primary testicular DLBCL compared to prior reports.
Subject(s)
Humans , Central Nervous System , Diagnosis , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Lymphoma , Lymphoma, B-Cell , Medical Records , Orchiectomy , Radiotherapy , Recurrence , Retrospective Studies , TestisABSTRACT
Primary testicular lymphoma comprises 1% to 9% of testicular neoplasms and represents 1% to 2% of all non-Hodg-kin lymphomas. Histologically, the majority of the tumor consists of diffuse large B-cell non-Hodgkin lymphomas that are of intermedi-ate- or high-grade neoplasm. Clinically, the disease typically presents as a painless testicular swelling that develops over a span of weeks to months. B symptoms such as fever, weight loss, and anorexia are present in 25% to 41% of the patients. This tumor is an ag-gressive type, with frequent invasion of the epididymis, spermatic cord, and scrotum, as well as a marked tendency to relapse, especial-ly in the CNS. The treatment is mainly based on orchiectomy (mostly in stages ⅠE and ⅡE) regardless of its association with prophy-lactic irradiation of the scrotum and administration of intrathecal chemotherapy, cyclophosphamide, doxorubicin, vincristine, and pred-nisone regimen chemotherapy plus rituximab (R-CHOP) (stages ⅢE and ⅣE) and radiotherapy. The multi-modality treatment marked-ly improved progression-free and overall survival. We introduce as reference one case that received a multidisciplinary comprehensive discussion in the Department Lymphoma, Tianjin Medical University Cancer Hospital.
ABSTRACT
Objective Concluding the clinical feature and prognosis of primary testicular lymphoma to improve the understanding of this disease.Methods During 1995 and 2010,17 cases of primary testicular lymphoma treated in Beijing Friendship Hospital of Capital Medical University were retrospectively analyzed of its clinical features,diagnosis,treatment and prognosis.Results Seventeen patients with a mean age of 68 years complained the testicular sohd mass as their first symptoms.The mean tumor diameter was 4.7 cm,and all patients underwent orchidectomy,and testicular non- Hodgkin's lymphoma was confirmed by pathologic examination.Fourteen cases were diffuse large B cell type and 3 cases were anaplastic large cell type.The clinical stage of all the patients was IE.Fourteen cases were followed up (3 cases were lost)with mean follow-up time of 37.8 months by outpatient interview and telephone,all patients were treated with CHOP chemotherapy,and some of them were combined with rituximab and preventive lowdose pelvic radiotherapy.Five cases died of other chronic medical complications,1 case with contralateral testicular metastasis received surgery again.There were 9 tumor free survival cases in total.Conclusion Primary testicular lymphoma is rare and more common in older men.Postoperative pathologic diagnosis is gold standard.The systemic treatment and individual therapy is the first choice for primary testicular lymphoma.
ABSTRACT
Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma (PTL). Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation(range 33-81 years). Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin's lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission, with a median follow-up of 23 months (4-231 months). The 5 years and 10 years of overall survival was 39.1% and 19.5%. The effect of patients who received chemotherapy≥4 cycles and B cell lymphoma patients combination with Rituximab were better. In multivariate analysis, Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival. Conclusions Primary non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after orchiectomy should be recommended. Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival in PTL.