Lymphadenopathy of sinus histiocytosis mimicking metastatic bladder cancer: a case report

Abstract

A case of invasive bladder cancer accompanied with enlarged pelvic lymph nodes, which were interpreted as metastasis, is reported. The lymphadenopathy eventually regressed spontaneously while the bladder cancer increased in size. Total cystectomy and pelvic lymph node dissection were performed. Histopathological examination of the lymph nodes revealed dilation of the sinuses and marked increase in the number of histiocytes, which suggested sinus histiocytosis. Sinus histiocytosis is often associated with malignant tumor. It is considered as a sign of the host's immune activation with favorable prognostic significance. Nevertheless, such lymphadenopathy mimics a metastatic lymph node, making proper staging difficult.

A longitudinal MRI study on lymph nodes histiocytosis of a xenograft cancer model

“…The lymph node structure harbours cell populations of the innate and adaptative immune system which, in principle, will have a capacity of tackling the metastatic spread [6, 7, 8]. In fact, lymph node activation with histiocytosis described in patients with several cancers, such as breast [9], head and neck [10] and bladder [11] was a good prognostic indicator for survival. On the contrary, lymphatic metastasis is an early event within the tumor progression that is considered a key factor in poor prognosis, especially after resection of the tumoral mass [12].…”