Testicular involvement in leukemia and lymphoma

Microscopic testicular infiltration was found at autopsy in 64.3% of 140 males with acute leukemia, 22.4% of 76 males with chronic leukemia, 18.6% of 102 males with lymphosarcoma, and in none of 44 males with Hodgkin's disease. Two children with lymphomatous testicular involvement had the features of Burkitt's lymphoma. In both leukemia and lymphoma, testicular involvement at autopsy was usually associated with widespread and extensive infiltration elsewhere. Patients with acute leukemia dying with chemotherapy-induced bone marrow hypoplasia often had persistent extramedullary infiltrates; such sites were typically multiple and did not notably favor either the testis or the leptomeninges—lymph nodes, spleen, liver, kidneys, and gastrointestinal tract were as commonly or more commonly so involved. Clinically evident testicular involvement in acute leukemia has apparently increased in frequency, perhaps reflecting longer survival since the advent of chemotherapy. This complication often develops while the patient is in hematologic remission and may be followed by leukemic masses in distant sites before hematologic relapse. Six of 8 children with testicular tumefaction due to acute leukemia showed testicular fibrosis at autopsy.