原发性睾丸非霍奇金淋巴瘤

<title>imary testicular non-Hodgkin's lymphoma

原发性睾丸非霍奇金淋巴瘤(NHL)极少见,仅占所有:NHL的1％-2％,弥漫大B细胞淋巴瘤是最常见的病理类型。多发于60岁以上老年人。对侧睾丸受侵率高,易侵及中枢神经系统、皮肤等结外器官。ⅠE／ⅡE期病人睾丸切除术后综合治疗可降低复发率,提高生存率。晚期病人以化疗为主。对侧睾丸预防照射可降低其复发率,但中枢神经系统的预防性鞘内注药是否降低复发率还有争议。该病复发率高,预后差,国际预后指数与其预后相关。

<abstract>imary testicular NHL is a rare disease, accounting for 1%-2% of all NHL. The majority of patients have diffuse large B-cell lymphoma. Most patients are more than 60 years old. Central nervous system (CNS) and contralateral testis are most likely involved, as well as skin. For early stage patients, combined modality therapy after orchiectomy is able to decrease the recurrent rate and improve the survival rate. Patients with advanced disease are mainly treated with chemotherapy. Prophylactic radiation of the contralateral testis can successfully prevent its recurrence. Prophylactic intrathecal chemotherapy for CNS remains controversial. Patients present a high relapse rate and poor prognosis. International Prognosis Index(IPI)is associated with its prognosis.