Thirty-five patients with malignant lymphoma of the testis were reviewed. The lymphomas were classified by the Rappaport criteria and the recently introduced Working Formulation of non-Hodgkin's Lymphomas. The great majority of cases were diffuse histiocytic lymphoma (Rappaport), and these could be further subclassified by the Working Formulation. Significant differences in survival were observed between histologic subgroups of the Working Formulation and this effect was independent of stage, which also had a significant effect on survival. Of 23 clinically evaluable patients who presented with testicular lymphoma, eight of 17 patients with intermediate-grade lymphomas are alive and well, in contrast to none of six patients with high-grade lesions. The recognition of histologic subtype as a prognostic factor independent of clinical stage is important for postorchiectomy management of these patients.
Cancer 48:2O95-2 102. I98 I .
Y M P t l o M A s ACCOUIVT for approximately 5% of tes-L ticular neoplasms,' and they are the most common testicular malignancy of elderly men.2*3 Most cases represent the initial manifestation of occult disseminated disease, whereas others appear to be primary lymphomas, and as such constitute a distinct clinicopathologic en tit^.^.^ Diffuse histiocytic lymphoma is the most common histologic pattern of testicular lymphoma.
Other histologic types reported include poorly differentiated lymphocytic lymphoma,'.'O lymphoblastic lymphoma,' extramedullary plasmacytoma,6.' ' . 1 2 . ' 3 immunoblastic l y m p h ~r n a , ' ~ diffuse mixed lymphocytic and histiocytic