Motyčková Monika, Vosáhlová Vladimíra, Belada David, Šimkovič Martin, Žák Pavel
Vnitr Lek. 2017 Summer;63(6):415-422.
Primary testicular lymphoma (PTL) is a rare form of extranodal lymphoma and accounts for approximately 1 to 2 % of all non-Hodgkins lymphoma and 5 % of testicular malignancies. PTL typically affects patients older than 60 years. The most common clinical symptom is painless scrotal swelling. The ultrasound of testicles followed by orchiectomy and histological and imunohistochemical examinations are the most important tools for diagnostic assessment. Diffuse large B cell lymphoma (DLBCL) is the most common histological type of PTL. Orchiectomy is an important part of the treatment, which includes the combination of systemic imunochemotherapy and prophylactic modalities such as radiotherapy of contralateral testis and central nervous system (CNS) prophylaxis. This combined treatment approach improved the outcome of patients with PTL, however, the high frequency of extranodal relapses including CNS involvement represents a significant problem. The prognosis of PTL still remains less favorable in comparison to the some subtypes of non-Hodgkins lymphomas.Key words: central nervous system lymphoma involvement prophylaxis - primary testicular lymphoma - prognosis - radiotherapy - relapse.
原发性睾丸淋巴瘤(PTL)是一种罕见的结外淋巴瘤形式,约占所有非霍奇金淋巴瘤的1%至2%,占睾丸恶性肿瘤的5%。PTL通常影响60岁以上的患者。最常见的临床症状是无痛性阴囊肿大。睾丸超声检查,随后进行睾丸切除术以及组织学和免疫组织化学检查是诊断评估的最重要工具。弥漫性大B细胞淋巴瘤(DLBCL)是PTL最常见的组织学类型。睾丸切除术是治疗的重要组成部分,治疗包括全身免疫化疗与预防性治疗手段相结合,如对侧睾丸放疗和中枢神经系统(CNS)预防。这种联合治疗方法改善了PTL患者的预后,然而,包括CNS受累在内的结外复发高频率是一个重大问题。与某些非霍奇金淋巴瘤亚型相比,PTL的预后仍然较差。关键词:中枢神经系统淋巴瘤受累预防 - 原发性睾丸淋巴瘤 - 预后 - 放疗 - 复发