Lymphoma of the prostate, either primary or secondary, is very rare. We report the case of an 82-year-old man with symptoms of bladder outlet obstruction presumably due to benign prostate hyperplasia (BPH). He underwent an uneventful transurethral resection of the prostate. Pathological review of the resected tissue demonstrated substantial infiltration by an atypical lymphoid infiltrate positive for CD20, BCL2, CD5, k light chain and cycline D1. Histology and immunoprofile were consistent with mantle cell lymphoma.
Can Urol Assoc J 2009;3(6):E94-E95
Case reportAn 82-year-old man presented with increasing symptoms of bladder outlet obstruction. His medical history included repair of an abdominal aortic aneurysm in late 2005 followed by a brief period of urinary retention that spontaneously resolved. He also had hypercholesterolemia and diabetes. He had no family history of prostate cancer and his prostate-specific antigen (PSA) level was 2.4.Cystoscopy demonstrated a moderately large prostate with a prominent middle lobe and a moderately trabeculated bladder with small diverticula. After medical therapy failed to improve his symptoms he underwent transurethral resection of the prostate. We resected 28 g of tissue with substantial clinical improvement. Microscopically, the tissue was substantially infiltrated by an atypical lymphoid infiltrate positive for CD20, BCL2, CD5 (weakly), k light chain and cycline D1, consistent with mantle cell lymphoma ( Fig. 1 and Fig. 2).A computed tomography (CT) scan of his abdomen and thorax showed marked lymphadenopathy consistent with stage-IIIA mantle cell lymphoma. He had no constitutional or systemic symptoms. We referred him to a medical oncologist, and he received CHOP/Rituxan chemotherapy.