Primary Ureteral Lymphoma Presenting with Acute Flank Pain

Abstract

Non-Hodgkin's lymphoma (NHL) represents 4% of newly diagnosed cancer in 2013 with a 59-82% 5-year survival depending on the tumor location. Primary presentation of lymphoma consists of lymphadenopathy or swelling of the lymph nodes and non-specific systemic symptoms such as fevers, night sweats, and weight loss. Less commonly, NHL arises from non-lymphoid tissue. We report a unique case of NHL arising from the ureteral wall which was visualized via non-contrast CT and direct vision through ureteroscopy.

Ultrasonographic diagnosis of a lymphomatous lymph node presumptively infiltrating the ureter causing hydronephrosis in a 3‐year‐old dog

“…It was determined to be direct extension tissues of the ureter, though some papers alluded to the possibility in humans. 14 In most cases where hydronephrosis was found secondary to a separate abdominal mass, it was due to compression of the ureter by the mass itself or associated fibrotic tissue. [15][16][17][18] Obstruction secondary to infiltrative disease was decided in this case with the appearance of the mass entering the ureter and extending distally into the UVJ where it was then visualized within the bladder.…”

“…Within both veterinary and human literature, the author was unable to find any reports of a separate neoplastic organ invading the tissues of the ureter, though some papers alluded to the possibility in humans 14 . In most cases where hydronephrosis was found secondary to a separate abdominal mass, it was due to compression of the ureter by the mass itself or associated fibrotic tissue 15–18 .…”

Ureteric lymphoma as a rare cause of right lower ureteric obstruction

“…Involvement of the ureter in lymphomas could be a result of ureteric wall involvement, direct extension or compression from retroperitoneal lymph nodes. Primary ureteric lymphomas are exceedingly rare, with only 21 cases reported in the literature so far 2. We report a case of a 45-year-old man who presented with right flank pain and weight loss, and who was found to have a stricture in the right lower ureter causing ureteral obstruction, diagnosed to be due to lower ureteric non-Hodgkin lymphoma (NHL).…”