Testicular Lymphoma : Prognosis
Prognosis of Diffuse Large B-cell Lymphoma (DLBCL) of the Testis: Almost 80% of patients go into remission. The median survival for patients with Stage I or II disease is about 5 years. However, relapses are common and can occur several years after orchiectomy. They usually involve extranodal sites such as the CNS (parenchymal > meningeal), contralateral testis, bone, lung, skin, and sometimes, the lymph nodes. For advanced stage disease, the 5-yr survival rate is less than 20%. Features associated with favorable outcome include: localized disease, sclerosis, a component of follicular lymphoma, unilateral (as opposed to bilateral) involvement, and right-sided tumor. Features associated with poor prognosis include: advanced stage, decreased serum albumin, elevated LDH levels, involvement of adjacent structures (spermatic cord, epididymis, scrotum), large tumor (> 9 cm), and failure to achieve remission. This image from a testicular DLBCL shows large atypical lymphoid cells (CD20+) and numerous small reactive lymphocytes (CD3+ T-cells) in a somewhat sclerotic stroma.