title: Primary Diffuse large B-Cell lymphoma of testis: A single centre experience and review of literature.
abstract: BACKGROUND
  Primary testicular lymphoma constitutes 1-2% of Non-Hodgkin's lymphomas affecting elderly men >60 years of age. Most often it is a Diffuse large B cell lymphoma (DLBCL) and treatment involves multimodality approach involving surgery, chemotherapy and radiotherapy. Outcome remains poor in spite of aggressive therapy.
  
  
  METHODS
  We retrospectively reviewed 286 registered cases of DLBCL (aged >14 years) from 2007 to 2011 and found nine primary testicular involvement patients. These cases were analyzed for baseline clinical features, investigations, staging, treatment and outcome.
  
  
  RESULTS
  Median age was 58 (46-76) years. All patients presented with testicular swelling, two had the presence of B symptoms, and three with abdominal lymphadenopathy. Six had stage IE disease and three patients had stage IIE. All patients underwent orchiectomy. Eight patients received combination chemotherapy and six completed three or more cycles. Four achieved complete response, among these three relapsed after 32, 42, 70 months and one was lost to follow up. Two had a progressive disease, among these one died of disease and one alive with disease. Complete follow up was available from five patients and median survival was 36 months (11-78 months).
  
  
  CONCLUSIONS
  Primary testicular DLBCL is uncommon, needs multimodality treatment and central nervous system prophylaxis to improve the survival. The outcome needs to be further investigated using biological approaches (Rituximab based) and/or more aggressive management.
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: Kadabur Nagendrapp
authors.initials: KN
authors.lastname: Lokesh
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: Vishwanath
authors.initials: V
authors.lastname: Sathyanarayanan
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: C Lakshmaiah
authors.initials: CL
authors.lastname: Kuntegowdanahalli
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: T M
authors.initials: TM
authors.lastname: Suresh
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: Lokanatha
authors.initials: L
authors.lastname: Dasappa
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
authors.forename: Govinda Babu K
authors.initials: GB
authors.lastname: Kanakasetty
keywords: Diffuse large B cell lymphoma; Non-Hodgkin's lymphoma; testis