Testicular Lymphoma/Leukemia





KEY FACTS


Terminology





  • Infiltrative neoplasm of testis in which tumor cells surround and compress seminiferous tubules and normal testicular vessels



Imaging





  • Bilateral, solid, hypoechoic, hypervascular nodules/masses



  • Diffuse hypoechoic testis with hypervascularity



  • Striated pattern



  • Testicular shape not altered



  • Normal testicular vessels with straight course crossing through lesions



Pathology





  • Most commonly secondary lymphomatous involvement of testis; rarely primary



  • Lymphoma behaves similar to leukemia with abnormal cells diffusely infiltrating interstitium with compression of seminiferous tubules without causing their destruction



  • Testis is “sanctuary organ”: Blood gonad barrier limits accumulation of chemotherapeutic agents



Clinical Issues





  • Stages IE and IIE: Orchidectomy



  • Stages IIIE and IVE: Systemic chemotherapy using cyclophosphamide, doxorubicin, vincristine, and prednisolone



  • Radiation in symptomatic and bulky deposits



  • Lymphoma accounts for ~ 5% of all testicular tumors



  • Most common bilateral testicular tumor



Scanning Tips





  • Side-by-side comparison of both testes in single image with both grayscale and color Doppler is essential to assess for symmetry in size, echogenicity, and vascularity




    • Do not use dual image/split screen because scan parameters, such as TGC or color Doppler scale, may be altered between windows





Nov 10, 2024 | Posted by in ULTRASONOGRAPHY | Comments Off on Testicular Lymphoma/Leukemia

Full access? Get Clinical Tree

Get Clinical Tree app for offline access