Primary Testicular Lymphoma

Primary Testicular Lymphoma is a rare type of cancer that starts in the testicles, which are part of the male reproductive system. It involves the uncontrolled growth of lymphocytes, a type of white blood cell important for the immune system. This cancer mainly affects older men and can cause a painless swelling or lump in one or both testicles. Because the testicles are involved, it can impact fertility and hormone production. The disease can also spread to other parts of the body, including the central nervous system, which can lead to more serious health problems. Early detection is important for managing symptoms and improving outcomes.

Primary Testicular Lymphoma (PTL) is a rare extranodal form of non-Hodgkin lymphoma that originates in the testicular tissue without prior or concurrent systemic lymphoma. It is predominantly a diffuse large B-cell lymphoma (DLBCL) subtype, characterized by malignant proliferation of large B lymphocytes within the testis. PTL primarily affects older men, typically over 60 years of age, and is notable for its aggressive clinical course and high risk of relapse, especially in the central nervous system (CNS) and contralateral testis. The pathogenesis involves immune evasion and local immune privilege of the testicular microenvironment. Clinically, it presents as a painless testicular mass, often unilateral, with possible systemic symptoms in advanced stages. PTL requires differentiation from secondary testicular involvement by systemic lymphoma due to differences in prognosis and treatment.