Monoclonality of asynchronous bilateral lymphoma of the testis

Objectives: Lymphoma is the most frequent testicular malignancy in men over 60 years of age. Even though patients present initially with localized dis ease, the high incidence of bilateral involvement, synchronous or not, and early systemic dissemination are characteristic of these neoplasms. Sometim es the interval between tumor involvement of both testes is long. The quest ion is raised whether either the patient has a predisposition to present ne w clones of transformed lymphocytes, or the same disease using the same pat hway from a systemic reservoir infiltrates the contralateral testis. Method: Polymerase chain reaction and DNA sequencing were used to detect im munoglobulin heavy chain (IgH) rearrangement in paraffin-embedded specimens from asynchronous tumors affecting the right and left testis of a 85-year- old man with an interval period of 13 months. Results: Both tumors showed the same IgH rearrangement. Conclusions.. The lymphoma affecting the left and right testis derived from the same clone. It makes a strong case that lymphoma of the testis is the first manifestation of a systemic disease and should be treated aggressivel y early at the beginning of the disease. Copyright (C) 2000 S. Karger AG. B asel.