Testis & paratestis
Other tumors
Lymphoma
Author: Jennifer Gordetsky, M.D.
Last author update: 1 October 2013
Last staff update: 31 December 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Testicular lymphoma [title]
Table of Contents
Definition / general | Epidemiology | Clinical features | Radiology description | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Gordetsky J. Lymphoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testislymphoma.html. Accessed June 1st, 2023.
Definition / general
- Either primary or secondary involvement of testis by malignant / clonal lymphocytes
- Almost always diffuse large B cell lymphoma
- Also anaplastic lymphoma, Burkitt lymphoma, Hodgkin lymphoma, peripheral T cell lymphoma, follicular lymphoma
Epidemiology
- ~5% of testicular malignancies
- Most common malignant testicular neoplasm in men over 60 years although can occur at any age (range 16 to 91 years, median age 67) (Clin Oncol (R Coll Radiol) 2012;24:358)
Clinical features
- Painless testicular mass
- Bilateral testicular involvement in up to 35% of cases; often spreads to CNS
Radiology description
- Gray scale and color Doppler ultrasound findings include diffuse testicular infiltration / enlargement with hypervascularity or multifocal areas of hypoechoic, solid and hypervascular nodules within testes (Ultrasound Q 2013;29:247)
Prognostic factors
- Better prognosis if testis involvement is primary site (60% 5 year survival vs. 17% for disseminated disease / other stages) and unilateral
Case reports
- 6 year old boy with primary follicular large cell lymphoma (Arch Pathol Lab Med 2001;125:551)
- 40 year old man with peripheral T cell lymphoma presenting as testicular mass (World J Surg Oncol 2013;11:68)
- 50 year old man with primary testicular lymphoma with rupture (J Nat Sci Biol Med 2013;4:232)
Treatment
- Orchiectomy and chemotherapy
Gross description
- White tan pink, fleshy, resembles seminoma, often extratesticular involvement
Gross images
Images hosted on other servers:
Diffuse large B cell lymphoma
Microscopic (histologic) description
- Splaying apart but relative sparing of tubules by lymphoma cells
- Malignant cells are pleomorphic and noncohesive with large irregular nuclei and prominent nucleoli
- May have vascular invasion and sclerosis of seminiferous tubules
- No intratubular germ cell neoplasia
Microscopic (histologic) images
Images hosted on other servers:
Diffuse large B cell lymphoma
Peripheral T cell lymphoma
Positive stains
- LCA / CD45
- Other results dependent on lymphoma subtype
Differential diagnosis
- Chronic orchitis: patchy heterogenous infiltrate
- Granulocytic / myeloid sarcoma
- Seminoma (classic)
- Spermatocytic seminoma
Additional references
