Imaging diagnosis of testicular lymphoma.

Testicular lymphoma is a rare clinicopathologic entity that has rapid progression and poor prognosis. This report describes a case of a 62-year-old man who presented with a large testicular tumor and extensive lymphadenopathy along the spermatic cord and gonadal vessels to the renal vein level. Testicular lymphoma was considered, and biopsy confirmed a non-Hodgkin, large, B-cell lymphoma. The distribution of lymphadenopathy differs from that of paraaortic lymph nodes that present as other testicular tumors (seminoma or nonseminoma). The finding may be a useful characteristic for timely diagnosis of testicular lymphoma, although the diagnosis should be suspected in an older patient who presents with a testicular neoplasm and increased lactic dehydrogenase levels but without increased alpha-fetoprotein and human chorionic gonadotropin levels.