Primary testicular lymphoma: A strictly homogeneous hematological disease?

Abstract

Abstract. Primary testicular lymphomas display mostly aggressive diffuse large cell B-cell lymphomas, which could be further subclassified into germinal center B-cell-like and an activated B-cell phenotype via immunohistochemistry. A retrospective analysis of primary testicular lymphomas diagnosed at the Institute of Pathology, Salzburger Landeskliniken (SALK) between January 1997 and December 2008 was done. Immunohistochemical staining and complete clinical data evaluation was carried out and linked to overall survival time. We found 18 cases of primary testicular lymphoma diagnosed in elderly patients showing no side predilection and having an aggressive clinical behavior with short overall survival independent of treatment. The lymphomas could for the most be classified into diffuse large cell B-cell lymphomas [15/18 (83.3%)] showing a nonsignificant prevalence of activated B cell phenotype [9/15 (60%)] compared to the germinal centre phenotype [6/15 (40%)]. Two of the cases were mantle cell lymphomas consisting of the infrequent pleomorphic subtype. The survival analysis revealed no significant difference for any of the investigated antigens. Primary testicular lymphomas are for the most DLBCL, but subtype classification reveal molecular heterogeneity inside this lymphoma entity. A distinction between those subtypes is necessary because of different clinical behavior and treatment.

Primary large B-cell lymphoma of the adrenal gland has similar clinical, pathological, and genetic features to the primary large B-cell lymphoma of immune-privileged sites

“…Our results underscore the distinct immunophenotypic and chromosomal features of PA-LBCL, notably characterized by a high prevalence of the non-GCB phenotype and a notable absence of BCL2 and C-MYC rearrangements. These features align closely with those reported in IP-LBCL [2][3][4][32][33][34][35], suggesting shared pathogenic pathways, possibly in uenced by the unique microenvironments of immune-privileged sites. The absence of 'double-hit' genetics in PA-LBCL, a factor often associated with poorer prognosis in B-cell lymphomas, hints at an oncogenic mechanism distinct from SA-LBCL and may contribute to the relatively better prognosis in PA-LBCL cases.…”