Abstract
Objective:Primary testicular lymphoma (PTL) is a form of extra-nodal lymphoma originating from the testicles. Currently, positron emission tomography (PET) with glucose analogue 18F-fluorodeoxyglucose (18F-FDG) is the most popular and widely used modality for evaluating tumor metabolism, and PTL usually displays increased 18F-FDG uptake. Despite the rapid increase in clinical applications of FDG PET/ computed tomography (CT), its role in PTL has neither been clearly defined nor reviewed systematically. This study reviews the usefulness and limitation of FDG PET/CT in the diagnosis and treatment of PTL.Methods:This study included 12 patients with PTL between 2004 and 2015. We retrospectively examined PET/CT results along with patient outcome. The maximum standardized uptake value (SUVmax) was calculated.Results:The mean overall survival (OS) and disease-free survival (DFS) was 44.5 months and 35.5 months, respectively. The mean SUVmax was identified as 18.5 in recurrent/metastatic group. The 1-year and 3-year OS was 94% and 69%, while the 1-year and 2-year DFS was 93.5% and 56%, respectively.Conclusion:FDG PET/CT is very helpful in both staging and evaluating treatment response. Although it is not a perfect tool in the initial diagnosis, it might aid in the differential diagnosis of challenging testicular tumors. Pre-treatment and post-treatment FDG uptake values may also have a prognostic value in patients with PTL.
Highlights
Primary testicular lymphoma (PTL) is a form of extra-nodal lymphoma originating from the testicles [1]
The utility of FDG positron emission tomography (PET)/computed tomography (CT) is currently increasing in the management of PTL
This review summarizes the usefulness and limitations of FDG PET/CT in the diagnosis and treatment of PTL
Summary
Primary testicular lymphoma (PTL) is a form of extra-nodal lymphoma originating from the testicles [1]. PTL constitutes approximately 1-2% of all non-Hodgkin lymphomas (NHL) and accounts for 1-9% of all testicular tumors [2]. Most patients are older than 60 years of age, with PTL being the most frequent testicular neoplasm in this age group [3]. 80-98% of PTLs are diffuse large B-cell lymphomas (DLBCL) [4,5]. Synchronous bilateral involvement occurs in 6-10% while systemic disease is present in 20-30% of the patients [6]. The median overall survival (OS) of PTL is reported to be 4-5 years [7]. The most common metastatic sites are contralateral testicle, central nervous system (CNS), skin, adrenal glands, bone marrow, lung and pleura [8]
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