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Lymphoma of Testis

Last updated Nov. 3, 2018

Approved by: Maulik P. Purohit MD, MPH

DoveMed.com

Lymphoma of the Testis is a blood cell cancer affecting the lymphatic cells, or lymphocytes, in the testis. It is the most common form of testicular cancer that has originated outside the testis. This is a microscopic pathology image showing marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) type (MALT-type lymphoma, MALT lymphoma).


What are the other Names for this Condition? (Also known as/Synonyms)

  • Lymphoma of the Testicles
  • Primary Testicular Lymphoma
  • Testicular Lymphoma

What is Lymphoma of Testis? (Definition/Background Information)

  • Lymphoma of the Testis is a blood cell cancer affecting the lymphatic cells, or lymphocytes, in the testis. It is the most common form of testicular cancer that has originated outside the testis
  • The testes are the male reproductive organs, equivalent to the ovaries in women. They are housed in the scrotum; the sac-like structure in the groin. The testis have 2 main functions:
    • Male hormone production
    • Sperm production        
  • Lymphocytes are the main white blood cells found in the lymph, which is the fluid of the lymphatic system; much like blood is the fluid of the circulatory system
  • Lymph results from filtration of blood as it travels to and from tissues. Lymph is colorless because it lacks red blood cells; instead, it contains lymphocytes. It is central to the immune system. There are 3 different kinds of lymphocytes:
    • T-lymphocytes or T cells: Combat infections and abnormalities within cells (cell-mediated immunity). They fight viruses and cancerous cells
    • B-lymphocytes or B cells: Produce antibodies that are bodily defense proteins, which target foreign invaders outside the cells (humoral immunity). They fight bacterial cells, cell fragments, and other immunogenic elements       
    • Natural killer cells or NK cells: Perform diverse functions related to both cell-mediated and humoral immunity. They also scout for cancer cells, a process called immunosurveillance
  • Lymphoma is cancer of the lymphocytes. It is believed to occur due to lymphocyte development abnormalities that result in uncontrolled growth and activity of lymphocytes
  • Lymphoma of the Testis may occur in 3 ways:
    • Appear in the testis after it has originated in the lymph nodes (the primary site of extranodal disease)
    • It may be associated with a severe, body-wide or systemic disorder      
    • Be the clinically significant result of a minor, clinically insignificant, systemic disorder 
  • Lymphoma of the Testis is a rare condition but the most common testicular cancer among men aged 50 and older. It makes up for only 10% of the testicular cancers and less than 2% of the lymphomas
  • However, it has a positive outlook after treatment; 88% of the affected individuals survive 10 or more years, with only 8% experiencing recurrences 

Who gets Lymphoma of Testis? (Age and Sex Distribution)

Males are at risk for Lymphoma of the Testis, particularly those over 50 years and over. 

What are the Risk Factors for Lymphoma of Testis? (Predisposing Factors)

Following are factors that increase one’s susceptibility to Lymphoma of the Testis:

  • Family history of immune disease
  • Age 60 years and older
  • Decreased immunity, especially due to HIV/AIDS
  • The presence of any systemic disease
  • Infertility
  • Smoking
  • Exposure to radiation and industrial chemicals
  • Chemotherapy
  • Viruses (in some rare cases)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Lymphoma of Testis? (Etiology)

The cause of Lymphoma of the Testis is unknown.

  • It is believed that abnormal development of lymphocytes gives rise to cancerous cells that lead to the formation of this condition
  • However, how this occurs and the factors that cause it remain under investigation

What are the Signs and Symptoms of Lymphoma of Testis?

Indications for Lymphoma of the Testis include:

  • Swelling in one or both testis, lump in the testis, testicular pain
  • Feeling of heaviness in the scrotum
  • Weight loss
  • Fever
  • Weakness
  • Trouble breathing
  • Headache
  • Low blood pressure
  • Anemia
  • Abdominal pain and swelling
  • Back pain
  • Swelling of the legs
  • Constipation
  • Changes in appetite
  • Fatigue
  • Frequent urination

How is Lymphoma of Testis Diagnosed?

Following are techniques that aid in identifying Lymphoma of the Testis:

  • Physical examination to detect lumps in the testicles, which do not allow light to pass through
  • Tissue biopsy followed by microscopic analysis and staining
  • Blood tests that include:
    • Complete blood cell count (CBC) blood test
    • Liver function blood test (LFT)       
    • Serum tumor marker blood test to detect increases in human chorionic gonadotropin (hCG)
    • Alpha-fetoprotein (AFP) blood test
    • Lactate dehydrogenase (LDH) blood test
    • Testoserone levels blood test
  • Genetic testing to determine mutations associated with Testicular Lymphoma
  • Radiological imaging including:
    • X-Ray of the chest, abdomen, and pelvis
    • Ultrasound of the pelvis        
    • Computerized tomography (CT) scan of the brain
    • Vascular radiological studies
    • Whole body bone scan
    • Positron emission tomography (PET) scan 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Lymphoma of Testis?

Following are complications that may arise from Lymphoma of the Testis:

  • Infertility
  • Retrograde ejaculation
  • Excessive blood loss
  • Metastasis and the loss of function of the organ/area to which the cancer has spread

How is Lymphoma of Testis Treated?

Treatments for Lymphoma of the Testis may include the following procedures:

  • Removal of the testis
  • Debulking surgery to reduce tumor size, followed by chemotherapy
  • Clotting the vessels in the tumor (embolization)
  • Chemotherapy
  • Radiotherapy
  • Undertaking treatment of underlying conditions

How can Lymphoma of Testis be Prevented?

Lymphoma of the Testis may be avoided through the following measures:

  • Monthly testicular self-examination
  • Genetic testing in individuals with a family history
  • Limiting exposure to radiation and industrial chemicals
  • Limiting chemotherapy
  • Not smoking

What is the Prognosis of Lymphoma of Testis? (Outcomes/Resolutions)

  • The following factors determine the prognosis of the condition:
    • Size of the tumor
    • Stage of the tumor        
    • Age of the individual
    • Overall health of the individual
    • Location in the testes of the tumor
    • Number of tumor masses present within the testes
  • The prognosis for Lymphoma of the Testis is good. Individuals with this condition who have received surgical treatment, namely removal of the testicles, have an 88% survival rate over the next 10 years, with only an 8% chance of the cancer recurrence 

Additional and Relevant Useful Information for Lymphoma of Testis:

  • Testicular cancers are aggressive in nature; they are also very quick to develop. Nonetheless, they are readily treatable
  • Testicular cancer is the most common form of cancer in US men aged 15 to 35 years. However, it is still relatively uncommon, with 5,500 cases in the US each year and 0.2-10.3 cases worldwide per 100,000 persons
  • Additional reading references:

https://www.dovemed.com/diseases-conditions/leukemia-and-lymphoma/

https://www.dovemed.com/common-procedures/radiology-procedures/ultrasound-imaging-of-scrotum/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 5, 2015
Last updated: Nov. 3, 2018