Are there findings that are more suggestive of testicular lymphoma rather than testicular germ cell tumor?
Yes. Testicular lymphoma, which is almost always secondary to B cell non-Hodgkin’s lymphoma, usually occurs in men >50 years of age, and it is the most common testicular neoplasm in men >60 years of age.
On cross-sectional imaging, a nonspecific focal or diffuse homogeneous testicular mass is seen with increased blood flow on Doppler US and enhancement on CT and MRI. However, features that are more suggestive of lymphoma include tumor invasion of the epididymis or spermatic cord, indistinct tumor margins, preservation of a normal testicular contour, and bilateral testicular involvement.