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Seki H, Mizuno S, Saigusa S, Sugita Y, Iida Y, Shinohara S, Uchino K, Horio T, Hanamura I, Takami A. Primary Bladder Lymphoma with Extravesical Extension: A Case Report and Literature Review on Prognosis and Clinical Characteristics. J Clin Med 2024; 13:4340. [PMID: 39124607 PMCID: PMC11313225 DOI: 10.3390/jcm13154340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Primary bladder lymphoma is generally regarded as having a favorable prognosis due to the predominance of low-grade lymphomas confined to the bladder. However, our investigation reveals that cases with extravesical extension, predominantly involving diffuse large B-cell lymphoma (DLBCL), exhibit a distinct clinical course with varied prognostic outcomes. Methods: In this report, we present and analyzed the clinical features and outcomes of 47 patients with primary bladder lymphoma with extravesical extension, including the case that we experienced. Results: An 77-year-old man who experienced fever, anorexia, and general malaise was referred to our hospital. Initial laboratory tests indicated severe renal failure, pyuria, and Escherichia coli bacteremia, accompanied by diffuse thickening of the bladder walls and increased attenuation in the surrounding adipose tissues. Initially misdiagnosed with a severe urinary tract infection leading to sepsis, the patient was treated with antibiotics and hemodialysis. Upon readmission due to abdominal pressure, imaging identified an intra-abdominal mass connected to the bladder wall. A bladder biopsy was performed, resulting in the diagnosis of primary bladder DLBCL with perivesical extension, classified as germinal center B-cell type. Taking inspiration from this case, the review of 46 patients was implemented. As a result, we resolved that primary bladder lymphoma often includes indolent types like Mucosa-associated lymphoid tissue lymphoma, but cases with extravesical expansion are predominantly DLBCL. Conclusions: This case emphasizes the diagnostic complexities of distinguishing primary bladder lymphoma from urinary tract infections and underscores the prognostic implications of extravesical extension. Our comprehensive review of the literature on primary bladder lymphomas with extravesical involvement highlights the clinical characteristics, therapeutic challenges, and need for heightened diagnostic vigilance and tailored treatment strategies for this subset of patients.
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Affiliation(s)
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (H.S.); (S.S.); (Y.S.); (Y.I.); (S.S.); (K.U.); (T.H.); (I.H.); (A.T.)
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Costa S, Chacim S, Oliveira Â, Castro C. Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Urinary Bladder: A Case Report of a Rare Presentation. Cureus 2024; 16:e60885. [PMID: 38910656 PMCID: PMC11193677 DOI: 10.7759/cureus.60885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Primary lymphoma of the urinary bladder is extremely rare. We present the case of a 67-year-old woman diagnosed with primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) of the urinary bladder. The patient presented with macroscopic hematuria. Renal ultrasound revealed a solid vascularized mass, in the inferior wall of the bladder. Pelvic computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a polypoid lesion on the left side of the inferior bladder wall, measuring 40x45 mm, and the MRI study with gadolinium revealed that the entire bladder wall was involved. The patient underwent transurethral resection of the bladder tumor, demonstrating a histologic extensive involvement of bladder tissue by MALT lymphoma. The patient was treated with radiotherapy (24 Gy in 12 fractions) and four cycles of rituximab. She remained without evidence of disease 12 months later.
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Affiliation(s)
- Susana Costa
- Radiation Oncology, Instituto Português de Oncologia do Porto, Porto, PRT
| | - Sérgio Chacim
- Hematology, Instituto Português de Oncologia do Porto, Porto, PRT
| | - Ângelo Oliveira
- Radiation Oncology, Instituto Português de Oncologia do Porto, Porto, PRT
| | - Carla Castro
- Radiation Oncology, Instituto Português de Oncologia do Porto, Porto, PRT
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Zheng H, Du H, Liu J. Primary Bladder Non-Hodgkin Lymphoma: A Case Report. Cureus 2024; 16:e52688. [PMID: 38384624 PMCID: PMC10879654 DOI: 10.7759/cureus.52688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
Primary bladder lymphoma, a rare form of non-Hodgkin's lymphoma, is diagnosed through histopathology and immunostaining. Most bladder lymphomas are of the B-cell type, with a higher incidence in women and often presenting with hematuria. This report details an exceptionally rare case of primary bladder T-cell lymphoma. A 50-year-old male, without hematuria or other symptoms, was diagnosed during a routine ultrasound. A computed tomography scan showed a tumor located in the anterior, right, and posterior walls. The patient underwent transurethral resection of the bladder lesion. Pathological examination of the tumor showed that it was composed of lymphoid tissue, in accordance with peripheral T-cell lymphoma of non-Hodgkin subtype.
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Affiliation(s)
- Haobo Zheng
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
| | - Hao Du
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
| | - Junjiang Liu
- Urology, Hebei General Hospital, Shijiazhuang City, CHN
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Sain B, Blake M, Goyal K, Kaur H, Robinson K. Epstein-Barr virus-positive primary diffuse large B-cell lymphoma of the urinary bladder: a case report. J Surg Case Rep 2023; 2023:rjad111. [PMID: 36908691 PMCID: PMC9997550 DOI: 10.1093/jscr/rjad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 03/14/2023] Open
Abstract
Primary non-Hodgkin's lymphoma (NHL) of the urinary bladder is a rare event, with diffuse large B-cell lymphoma (DLBCL) being the most common form of NHL and urinary bladder lymphoma. It is an aggressive tumour with a poor prognosis if not recognised and treated early. The diagnosis is supported by radiological imaging and confirmed by histology, which shows the characteristic morphology of this lesion with further immunohistochemical analysis. Here we present a case of Epstein-Barr virus-positive DLBCL confirmed by an immunohistochemistry panel, along with a brief review of the literature focusing on diagnosis, treatment and outcome of this rare tumour.
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Affiliation(s)
- Baijaeek Sain
- Correspondence address. Clinical Fellow-ST1/2, Trauma & Orthopaedics, St. Mary’s & Charing Cross Hospitals, Imperial College Healthcare NHS Trust, London W6 8RF, UK. E-mail:
| | - Megan Blake
- General Surgery, The Grange University Hospital, Aneurin Bevan University Health Board, NHS, Cwmbran, Wales, UK
| | - Kanchan Goyal
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Harsimran Kaur
- Heartlands Hospital, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Kristina Robinson
- Royal Gwent Hospital, Aneurin Bevan University Health Board, NHS, Newport, Wales UK
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Tu X, Zhuang X, Li F, Huang C, Qian Y. Rare primary bladder mucosa-associated lymphoid tissue lymphoma: A case report and review of literature. Front Oncol 2023; 12:1042459. [PMID: 36686747 PMCID: PMC9849900 DOI: 10.3389/fonc.2022.1042459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Primary bladder mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare bladder tumor. Only scarce reports have been reported. We hereby report a case of an 81-year-old female patient with bladder tumor presenting with frequent urination and dysuria, whose pelvic magnetic resonance imaging (MRI) considered bladder cancer. She underwent transurethral resection of the bladder tumor (TURBT), and histopathology confirmed the mass to be bladder MALT lymphoma. The patient refused further treatment, and no disease recurrence one year after surgery. The current data are insufficient to draw conclusions about the long-term efficacy of treatment for this tumor, regular follow-up is necessary. To further understand the clinical features, pathology, treatment and prognosis of this tumor, we have searched the literature from 1990 to the present, analyzing a total of 64 cases of primary MALT lymphoma.
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Affiliation(s)
- Xi Tu
- Department of Urology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Xiyao Zhuang
- Department of Internal Medicine, Chengdu Shuangliu Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fen Li
- Department of Pathology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Chaoyou Huang
- Department of Urology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Youliang Qian
- Department of Urology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China,*Correspondence: Youliang Qian,
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Zanelli M, Sanguedolce F, Zizzo M, Palicelli A, Pellegrini D, Farinacci S, Soriano A, Froio E, Cormio L, Carrieri G, Cavazza A, Merli F, Pileri SA, Ascani S. Primary Diffuse Large B-Cell Lymphoma of the Urinary Bladder: Update on a Rare Disease and Potential Diagnostic Pitfalls. Curr Oncol 2022; 29:956-968. [PMID: 35200580 PMCID: PMC8870454 DOI: 10.3390/curroncol29020081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/05/2022] [Accepted: 02/09/2022] [Indexed: 12/18/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) represents the most frequent type of non-Hodgkin lymphoma. Globally, DLBCL is an aggressive disease, requiring an accurate diagnosis and prompt treatment. The diagnosis is often made on biopsy samples of a nodal mass, however, approximately 40% of DLBCL cases arise at extranodal sites. The most common extranodal site is the gastrointestinal tract, however any extranodal area may be primarily involved. Primary urinary bladder lymphoma represents only 0.2% of extranodal non-Hodgkin lymphomas, whereas secondary involvement of the urinary bladder by a systemic lymphoma is a more common event. Despite being rare, DLBCL is considered to represent the predominant primary urinary bladder lymphoma. The majority of cases reported in the bladder belong to the DLBCL, NOS group, and there are only rare cases of EBV-positive DLBCL, NOS. In this review, we summarize the current knowledge on DLBCL primarily occurring in the urinary bladder, with the aim of increasing clinician and pathologist awareness on this aggressive lymphoma rarely arising in the urinary bladder. Additionally, we focus on those entities which should be taken into consideration in the differential diagnosis, highlighting potential diagnostic pitfalls.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (E.F.); (A.C.)
| | | | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (E.F.); (A.C.)
| | - David Pellegrini
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (D.P.); (S.F.); (S.A.)
| | - Sabrina Farinacci
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (D.P.); (S.F.); (S.A.)
| | - Alessandra Soriano
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Elisabetta Froio
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (E.F.); (A.C.)
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (L.C.); (G.C.)
| | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (L.C.); (G.C.)
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (E.F.); (A.C.)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Stefano A. Pileri
- Haematopathology Division, European Institute of Oncology-IEO IRCCS Milan, 20141 Milan, Italy;
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (D.P.); (S.F.); (S.A.)
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