Primary testicular diffuse large B-cell lymphoma: a single center experience

Abstract

Objective To review the experience of the clinical diagnosis and treatment of primary testicular diffuse large B-cell lymphoma. Methods A review was made who were treated in the Tumor Hospital of Zhengzhou University from January 2011 to November 2018. The average age of the patients was 58 years old, with 4 cases in left side and 8 cases in right side. All patients were admitted to hospital with painless testicle mass. Solid mass of testis were detected by ultrasound with no abnormality in tumor markers. All patients underwent orchiectomy and followed by chemotherapy. Results Twelve primary testicular lymphoma (PTL) were identified by pathology, with 8 cases in phase I, 2 cases in phase II, 1 case in phase III , and 1 case in phase IV. The mean follow-up was 31 months. Inguinal orchiectomy was recommended as a diagnositc and initial therapy. All patients underwent R-CHOP/CHOP chemotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone with or without rituximab, including 6 cases with R-CHOP and 6 cases with CHOP. Nine of 12 patients underwent intrathecal prophylatic chemotherapy and 6 of 12 patients underwent contralateral testicle radiotherapy. Relapse occured in 2 patient with CHOP in central nervous system and died of the disease. One case with CHOP relapsed in abdominal cavity. No contralateral testicle relapse was observed. Conclusions PTL is a rare extranodal lymphoma. Painless testicle tumor in men over 50 years old should suspect of this disease. Inguinal orchiectomy is an important part of the treatment, which combines systemic chemotherapy and prophylactic modalities such as radiotherapy of contralateral testis and/or central nervous system (CNS) prophylaxis. Key words: Lymphoma, B cell; Testis; Treatment; Prognosis