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Primary and metastatic lymphoma of the testis – a review of the literature
Primary lymphoma of the testis is rare. The commonest type of lymphoma of the testis is diffuse large B-cell lymphoma, but other types of primary and metastatic lymphoma of the testis also occur. Diffuse large B-cell lymphoma usually manifests as a painless unilateral mass in older men. Children can also develop lymphoma of the testis. Constitutional symptoms may be experienced. Specimens for histological confirmation of this type of lymphoma are obtained through orchiectomy. Chemotherapy and radiotherapy are used to avoid or reduce recurrences. Intrathecal chemotherapy is also used to reduce recurrence in the central nervous system, but despite this central nervous system recurrences do occur. There is no consensus on the best chemotherapy regimen. It is important that a correct diagnosis is made based upon the microscopic and immunohistochemical characteristics of the tumour, because differentiation of diffuse large B-cell lymphoma from other types of lymphoma is helpful in selecting the correct chemotherapeutic regimen, and the appropriate regimen differs depending upon the specific type of lymphoma. There is a need for a global multicentre trial to identify the best treatment option for improving the long-term survival of patients and reducing central nervous system, extranodal and contralateral testis recurrences.