Klin Onkol 2007; 20(4): 302-306.
Background: Primary testicular lymphoma (TL) is a rare disease diagnosed mostly in men older than 60 years. The sporadic occurrence of TL leads relatively often to doubts in both the diagnostics and the therapeutic approach. Methods: We retrospectively analyzed a sample of 33 patients from the Czech Lymphoma Study Group registry to assess the pathohistological and clinical characteristics in these cases. Another 31 cases were identified in the routine and consultation histology files. Results: Histological diagnosis was predominantly (91%) diffuse large B-cell lymphoma (DLBCL). The most frequent clinical stage was I E A (60%), while 2 patients had initial CNS involvement. Treatment consisted in all cases of radical orchiectomy followed by chemotherapy in a majority of cases (82%). CNS prophylaxis was used in 13 patients (48%). Prophylactic irradiation of the contralateral testis was performed in 7 cases. The 2-year overall survival and progression-free survival reached 82% and 74%, respectively, in a median follow-up of 26 months. Eight of 33 patients have relapsed, 2 of them with no adjuvant treatment after orchiectomy. Conclusions: Primary TL is typically a diffuse large B-cell lymphoma occurring in old men, most of them presenting in stage I without systemic symptoms. The outcome of the TL patients appears to be worse than the results reported for nodal lymphomas. The late relapses, often extranodal, occur particularly in patients with inadequate initial treatment.
