Malignant lymphoma involving the prostate

Bostwick, David G.; Iczkowski, Kenneth A.; Amin, Mahul B.; Dişcigil, Güzel; Osborne, Barbara M.

doi:10.1002/(sici)1097-0142(19980815)83:4<732::aid-cncr15>3.0.co;2-t

Cited by 133 publications

(170 citation statements)

References 25 publications

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“…Th e largest case series comprising the pathology database of fi ve university hospitals spanning an aggregate of 200 years has documented only 62 cases of lymphoma of the prostate (1). A further review of 5962 autopsy specimens revealed that only 49 (0.82%) of the patients had non-Hodgkin's lymphoma of the prostate (3).…”

Section: Discussionmentioning

confidence: 99%

Mantle Cell Lymphoma of the Prostate Gland Treated with Holmium Laser Enucleation

Milburn

Cable

Trevathan

et al. 2017

Baylor University Medical Center Proceedings

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Mantle cell lymphoma of the prostate is rare and is seldom encountered in general urologic practice. It either arises primarily from the prostate or is a result of metastatic spread from another site. This specific type of lymphoma has an aggressive course and may respond poorly to traditional chemotherapy with frequent relapses. Mantle cell lymphoma occurs in middle age or older, which is also when symptoms of benign prostatic enlargement begin in men. This overlap makes the diagnosis of lymphoma of the prostate difficult and makes the treatment more complex. We describe a case of mantle cell lymphoma of the prostate that caused significant enlargement and bladder outlet obstruction with urinary retention. The obstruction was treated with holmium laser enucleation of the prostate with good functional results. L ymphoma of the prostate is an exceedingly rare entity, with less than 200 reported cases (1). Mantle cell lymphoma (MCL) of the prostate is even less common, with only 7 reported cases (2-6). We report a case of a 59-yearold man with MCL of the prostate that was discovered after holmium laser enucleation of the prostate. CASE PRESENTATIONA 59-year-old man was referred by his primary care provider for progressive lower urinary tract symptoms. He had been treated for MCL during the prior 8 years with several clinical relapses. Initially he was treated with traditional chemotherapy, and he received chemotherapy with autologous stem cell transplantation 2 years later for disease recurrence. He did well for many years and was successfully treated with salvage bendamustine/rituximab chemotherapy 6 months prior to his prostate surgery. A follow-up computed tomography scan after this latest treatment showed complete radiographic resolution of his lymphoma.Several months after completing the most recent chemotherapy, his symptoms of nocturia, hesitancy, urgency, and frequency eventually progressed to complete urinary retention. Digital rectal exam revealed an enlarged prostate without nodules and was overall considered benign. His prostate-specifi c antigen level was 1.2 ng/mL, and gland size measured 107 cm 3 , which yielded a PSA density of 0.01 ng/mL/cm 3 . Cystoscopy demonstrated a 5 cm-long prostate with bilobar enlargement and grade 3 trabeculation of the bladder. After discussing treatment options, the patient chose to undergo holmium laser enucleation of the prostate for relief of his urinary obstruction.During his surgery, the prostate tissue was very soft and required minimal laser energy to make the incisions in the prostatic adenoma. Establishing planes was challenging, especially in the 6 o'clock groove and lateral prostatic capsular dissection. It took 60 minutes to enucleate the gland and 20 minutes to morcellate all of the tissue. Th e total weight of enucleated tissue was 189 g. After an uncomplicated recovery in the hospital, the patient improved signifi cantly and was voiding spontaneously without any residual volume on postoperative day 1.Th e resected prostate tissue was infi ltrated by a hom...

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Section: Discussionmentioning

confidence: 99%

Mantle Cell Lymphoma of the Prostate Gland Treated with Holmium Laser Enucleation

Milburn

Cable

Trevathan

et al. 2017

Baylor University Medical Center Proceedings

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“…In accordance with the findings of other studies, nearly all cases of the genitourinary hematolymphoid neoplasms were B-cell non-Hodgkin's lymphomas. [3][4][5][6][7] Most cases in our series involved the kidney and testis; somewhat surprisingly, there were more lymphomas identified within the prostate than in the bladder. This most likely reflects the increased relative frequency of prostate biopsies rather than any increased propensity for lymphomagenesis.…”

Section: Discussionmentioning

confidence: 99%

“…The recognition of the presence of occasional rudimentary lymphoid nodules, cases of extramedullary hematopoiesis within the prostate, and documented cases of lymphoma limited to the prostate without pelvic or retroperitoneal lymph node involvement have shown that primary prostatic lymphomas exist. 5 Most primary lymphomas of the prostate are non-Hodgkin's lymphomas and are predominantly of B-cell lineage. In our series, DLBCL was the most common subtype, followed by SLL/CLL and follicular lymphoma, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown that prostatectomy as monotherapy may not be the most effective approach to treatment, but prognosis may be improved with adjuvant chemoradiation therapy. 5,26 Lymphomas of the bladder are also relatively uncommon and patients may present with hematuria as documented in two patients in our series. Patients have also been known to present with urinary obstruction.…”

Section: Discussionmentioning

confidence: 99%

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Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases

Schniederjan

Osunkoya

2009

Modern Pathology

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Lymphoid neoplasms of the urinary tract and male genital organs are relatively rare, comprising less than 5% of all primary extranodal lymphomas; only a handful of small case series and isolated case reports have been published describing their predominant sites and subtypes. We identified 40 patients with lymphoid neoplasms of the urinary tract and male genital organs. Hematoxylin and eosin slides and immunohistochemical stains were reviewed, and follow-up data were also obtained. Twenty-six of 40 cases (65%) were primary genitourinary lymphomas. Mean age at diagnosis was 56 years (range 4-86 years). Among renal, bladder, and ureter lymphomas, a male predominance was noted (1.6:1). The subtypes of the lymphoid neoplasms observed were diffuse large B-cell lymphoma (17 cases, 43%); Burkitt lymphoma, extranodal marginal zone lymphoma, SLL/CLL, and follicular lymphoma (4 cases, or 10% each); B-cell ALL (2 cases, 5%); B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, mantle cell lymphoma, plasmacytoma, polymorphic post-transplant lymphoproliferative disorder, and peripheral T-cell lymphoma NOS (1 case, or 2.5% each). In most cases, the genitourinary tract was the site of initial presentation. Genitourinary tract lymphomas most commonly occurred in the kidney. B-cell non-Hodgkin's lymphomas predominated, with diffuse large B-cell lymphoma being the most common subtype in the entire group. Extranodal marginal zone lymphoma was seen only in the kidney, rather than the bladder, where it is typically thought to be more common. Although this study confirms the predominance of diffuse large B-cell lymphoma in extranodal sites, the findings also highlight the variety of lymphomas that may occur in the genitourinary tract. This diversity of subtypes affirms the importance of fully characterizing lymphomas by immunohistochemistry and other modalities, which are indispensable for accurate diagnosis.

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“…[1][2][3] A group of B-cell lymphomas composed of small lymphocytes are characterized by relatively indolent clinical course. [4][5][6][7] These biologically indolent B-cell lymphomas includes the following five categories: small lymphocytic lymphoma/CLL (SLL/CLL), lympho-plasmacytic lymphoma (LPL), marginal zone B-cell lymphoma (MZBL) (aka MALT lymphoma), follicular lymphoma (FL), and mantle cell lymphoma (MCL).…”

Section: Introductionmentioning

confidence: 99%

Primary follicular lymphoma of the prostate

Terada

2016

CRCP

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Only 5 cases of follicular lymphoma (FL) have been reported in the prostate. A 68-year-old man presented with dysuria. Laboratory data did not indicate malignancy in the prostate with serums PSA of 4.6 ng/ml. Imaging techniques identified no tumors and lympho-adenopathy other than the prostatic enlargement. The patient was clinically diagnosed as prostatic hyperplasia, and trans-urethral resection of prostate (TURP) (65 g) was done. Histologically, the TURP-specimens showed severe nodular proliferation of atypical small lymphocytes consisting of small centrocytic lymphocytes and large centroblastic lymphocytes, the number of the latter being 2/HPF. Immunohistochemically, the tumor cells and nodular areas were positive for CD45, CD20, CD79a, bcl-2, bcl-6, and CD10. They were negative for pan-cytokeratin (AE1/3, CAM5.2), CD3, CD45RO, CD56, PSA, chromogranin-A, synaptophysin, NSE, CD138, CD15, CD30 and cyclin D1. No significant number of plasma cells were seen by immunohistochemistry for light chains and CD138. A pathological diagnosis of primary FL (grade 1) of the prostate was made. No tumors were identified by various imaging techniques, and the prostatic FL was diagnosed as primary. The patient underwent low-dose R-CHOP chemotherapy and focal radiation, probably resulting in complete remission. No recurrence has been found 5 months after the diagnosis.

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Malignant lymphoma involving the prostate

Cited by 133 publications

References 25 publications

Mantle Cell Lymphoma of the Prostate Gland Treated with Holmium Laser Enucleation

Mantle Cell Lymphoma of the Prostate Gland Treated with Holmium Laser Enucleation

Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases

Primary follicular lymphoma of the prostate

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