Malignant lymphomas of the testis

Background. The aim of the study was to analyse 10 patients with malignant lymphomas of the testis, and to discuss the necessity of immunocytochemical staining to confirm the histologic diagnosis and an effective treatment policy. Patients and methods. Ten patients with malignant lymphomas of the testis were reviewed in order to identify and study the incidence, histologic findings, the type of treatment administered and the overall outcome. Results. Testicular malignant lymphomas were identified ten times between 1984 and 1999. Bilateral tumours occurred simultaneously in 4 patients, and a metachronous malignancy and testicular relapses developed in 2 patients. Of the remaining patients 4 had unilateral testicular involvement. None had elevated AFP and β-HCG or a history of undecided testis. Eight of patients were younger than 50 years. Five of the lymphomas were high grade, 3 were intermediate and 2 were low grade diffuse non-Hodgkin’s lymphoma. All patients were initially treated with radical orchiectomy and were, according to their clinical stage, treated with chemotherapy and/or radiotherapy. Five of 10 patients were alive with no evidence of disease with follow-up ranging from 9 to 62 months. The remaining 5 patients died between 3 and 42 months respectively. Conclusions. Testicular lymphomas are similar to those of testicular germ cell tumours and account for approximately 5% of all testis tumours and represents 1% of all lymphomas. Testicular lymphomas differ from germ cell tumours of the testis by following points: (1) Testicular lymphomas tend to occur in the middle ages, (2) tumour markers AFP and β-HCG are in normal limits, (3) a development in cryptorchid testis is extremely rare, (4) an early systemic therapy is indicated and watchful waiting policy can not be performed, (5) the prognosis is poor. The recognition of histologic diagnosis with immunocytochemical staining for leukocyte common antigen (LCA) is essential and should help the future treatment policy.