For a patient with diffuse large B-cell lymphoma of the testicle, do you irradiate the contralateral testicle alone or do you recommend radiation to the lymphatics and remaining testicle?

The most common clinical scenario for primary testicular lymphoma is an older man presenting with a painless testicular mass who undergoes orchiectomy and is found to have DLBCL. Many patients will have stage I disease with post-orchiectomy PET-CT showing no other sites of involvement. Occasionally, a patient will also have retroperitoneal lymphadenopathy (stage II). Around 80% of patients will have early-stage disease.

Most patients will be treated with R-CHOP with some form of CNS prophylaxis ...