PRIMARY B CELL LYMPHOMA OF THE PENIS: SUCCESSFUL TREATMENT WITH ORGAN PRESERVATION

Primary Non-Hodgkin's Lymphoma of Penis Masquerading as a Non-Healing Ulcer in the Penile Shaft

Primary malignant lymphoma of the male external genitalia is extremely rare and it is even rarer in the penis. Because of its rarity, the possibility of delay in diagnosis and mismanagement is always there. It can present as a nodule, non-healing ulcer, stricture urethra or periurethral abscess. We report a case presenting first a nodule and later on as a non-healing ulcer which was diagnosed by corporal biopsy and managed successfully with chemotherapy.

Primary penile malignant lymphoma: report of a rare case

A 73-year-old male presented with a 3-month history of two penile masses: one on the shaft and one on the glans penis. Both lesions were poorly defined, fixated and without tenderness. The sizes were 1.0 × 1.0 × 1.0 cm and 1.2 × 1.5 × 1.5 cm, respectively. The patient underwent lumpectomy of the glans penis; we confirmed malignant lymphoma of the glans penis (B-cell derived; diffused large B-cell) by postoperative pathological examinations. CHOP (cyclophosphamide-hydroxydaunorubicin-oncovin-prednisone) chemotherapy was administered. The patient was tumour-free at the 33-month follow-up.

Plasmablastic lymphoma involving the penis: a previously unreported location of a case with aberrant CD3 expression

Lymphomas of the penis are rare and can either arise at this site or be a manifestation of systemic disease. We report the case of an elderly man with a plasmablastic lymphoma (PBL) involving the uncircumcised penile prepuce. The neoplasm was composed of plasmablasts positive for monotypic immunoglobulin lambda light chain, CD3, CD79a, CD138 and Epstein-Barr virus encoded RNA (EBER), and was negative for CD2, CD5, CD7, CD20, and PAX5. This case is highly unusual for at least two reasons. The penile foreskin is a rare location for lymphoma and PBL at this site has not been reported. Secondly, the tumour was shown by immunohistochemistry to be positive for the T-cell marker CD3. Lineage ambiguity in terminally differentiated B-cell lymphomas has been reported to be closely related with immune compromise and is associated with Epstein-Barr virus infection. The literature on penile lymphomas is also reviewed.

[Primary lymphoma of penis]

We describe a case of primary penis lymphoma in a 71 yr old man. We review the bibliography and we emphasize the peculiarity and different sorts of clinical presentation. The initial symptoms were insidious. Physical examination and ultrasound findings made it indistinguishable from other tumors. A MRI confirmed the presence of a tumoral process with a homogeneous density in the distal part of the penis whose biopsy with immune histological processing confirmed us the diagnosis of primary penis lymphoma. The combined treatment with chemotherapy and radiotherapy allowed preserving the sexual organ and being without disease at 48 month of follow up.

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

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.

Progressive painless swelling of glans penis: uncommon clinical manifestation of systemic non-Hodgkin's lymphoma

Malignant lymphomatous involvement of the glans penis is a rare phenomenon that can be observed in either primary or secondary cutaneous lymphoma. Multiple papules, solitary nodules of variable size, ulcers, or painless masses have rarely been reported as specific and early manifestations of systemic lymphoma. Other unusual manifestations include priapism (manifested as a painless persistent erection with a flaccid glans penis) and progressive diffuse penile swelling. We report the case of a 74-year-old man presenting with progressive painless induration and swelling of the glans penis associated with mild preputial edema as the initial manifestation of systemic non-Hodgkin's lymphoma.