Extranodal presentation of non-Hodgkin's lymphomas in the testis

The clinical and pathologic features of six patients, each of whom exhibited a testicular mass as the first sign of a lymphoma, are discussed. All underwent extensive staging procedures. Retroperitoneal lymph nodes and bone were frequent sites of extratesticular involvement early in the disease. Later widespread dissemination to multiple organs occurred in five of six patients. CNS involvement was a prominent feature of advancing disease. One patient was apparently cured by orchiectomy alone. Although the others exhibited partial responses to chemotherapy and radiation, the disease was fatal to all of them within a year of orchiectomy. Early, aggressive systemic treatment of these patients appears necessary.