Testicular Lymphoma
Review literature: (Fonseca u.a., 2000).
Definition of Testicular Lymphoma
Lymphoma of the testis may represent the primary manifestation of extranodal disease or a secondary manifestation of disseminated lymphoma.
Epidemiology
5% of all testicular tumors. It is the most common testicular tumor in men over 50 years.
Pathology of Testicular Lymphoma
Gross anatomy: diffuse enlarged testicles. Microscopy: all known forms of lymphoma may be possible.
Classification (Ann Arbor 1971):
Stage I:
Manifestation in a single lymph node region or a single extranodal organ (=IE).
Stage II:
Manifestation in several lymph node regions or organ regions on one side of the diaphragm.
Stage III:
Manifestation in several lymph node regions or organ regions on both sides of the diaphragm.
Stage IV:
Disseminated manifestation in visceral organs.
Signs and Symptoms
Testicular enlargement, a quarter of patients report about general symptoms such as weight loss, night sweats and weakness.
Diagnosis
Labatory tests:
Differential blood count, erythrocyte sedimentation rate, LDH, testicular tumor markers.
Tumor Staging:
If histology of the testis reveals lymphoma, the following tests are indicated: bone marrow biopsy, bone scan, CT abdomen and thorax.
Treatment of Testicular Lymphoma
Radical inguinal orchiectomy is the first step in diagnosis and therapy. For further treatment of lymphoma, see textbooks of oncology.
If testicular lymphoma is already suspected (before orchiectomy) in disseminated disease, testicular biopsy to confirm the diagnosis is sufficient. Orchiectomy is only necessary due to symptoms.
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References
- Fonseca u.a. 2000 FONSECA, R. ; HABERMANN, T. M. ; COLGAN, J. P. ; O’NEILL, B. P. ; WHITE, W. L. ; WITZIG, T. E. ; EGAN, K. S. ; MARTENSON, J. A. ; BURGART, L. J. ; INWARDS, D. J.:
- Testicular lymphoma is associated with a high incidence of extranodal
recurrence.
In: Cancer
88 (2000), Nr. 1, S. 154–61
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Deutsche Version: Lymphom des Hodens
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Dr. med. Dirk Manski
man...@urologielehrbuch.de