Updated 21 February 2006
Testicular lymphoma is almost always of an aggressive histologic subtype, usually diffuse large B cell type. In contrast to other patients with localized large cell lymphoma, patients with stage 1AE or 2AE testicular lymphoma are only cured about 50% of the time using brief chemotherapy and irradiation. Thus, the recommended treatment for all stages of testicular lymphoma is a full course of chemotherapy as for advanced disease. An additional problem often seen in patients with testicular lymphoma is relapse in the opposite testicle. This can be prevented by irradiation. Finally, patients with testicular lymphoma in association with stage 3 or 4 disease are at increased risk of CNS involvement and require prophylactic intrathecal chemotherapy. The following table summarizes these recommendations by stage:
| Stage |
Treatment |
| 1AE, 1BE |
Chemotherapy* + whole scrotum radiation |
| 2AE, 2BE |
Chemotherapy* + whole scrotum radiation |
|
+ involved field nodal irradiation |
| 3AE, 3BE, 4A, 4B |
Chemotherapy* + whole scrotum radiation |
|
+ CNS chemoprophylaxis |
*chemotherapy: CHOP+rituximab