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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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Xin JH, Jiang B, Yuan YH, Zou XF. Primary diffuse large B-cell lymphoma of the urinary bladder: A case report. Asian J Surg 2024; 47:1930-1931. [PMID: 38212225 DOI: 10.1016/j.asjsur.2023.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024] Open
Affiliation(s)
- Jian-Hui Xin
- The First Clinical College, Gannan Medical University, Ganzhou, China
| | - Bo Jiang
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yuan-Hu Yuan
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xiao-Feng Zou
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
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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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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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Khdhir M, El Annan T, El Amine MA, Shareef M. Complications of lymphoma in the abdomen and pelvis: clinical and imaging review. Abdom Radiol (NY) 2022; 47:2937-2955. [PMID: 35690955 PMCID: PMC10509750 DOI: 10.1007/s00261-022-03567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023]
Abstract
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
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Affiliation(s)
- Mihran Khdhir
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
| | - Tamara El Annan
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon
| | | | - Muhammed Shareef
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, CT, USA
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Ching D, Chiu SK, Van Vliet C, Jasim A. Primary ALK-Negative TP63-Rearranged Anaplastic Large Cell Lymphoma in the Bladder: Potential for Misdiagnosis. Int J Surg Pathol 2022:10668969221113481. [PMID: 35898185 DOI: 10.1177/10668969221113481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 76-year-old gentleman presented with persistent lower urinary tract symptoms. Multiple biopsies, radiological correlation and ancillary studies were required to achieve a diagnosis. The main differential diagnoses lies between urothelial carcinoma and anaplastic large cell lymphoma (ALCL), both of which are known to be positive for p63 and GATA3. An accurate diagnosis is crucial as the management is significantly different. To avoid misdiagnosis a comprehensive immunohistochemistry panel is necessary. Primary bladder lymphomas are rare. Our case represents the first case of primary ALK-negative TP63-rearranged ALCL. We reviewed the literature and discussed the potential pitfalls for misdiagnosis.
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Affiliation(s)
- Daniel Ching
- Department of Anatomical Pathology, Clinipath Pathology, Osborne Park, WA, Australia
| | - Sung-Kai Chiu
- Department of Haematology, St John of God Health Care Midland, WA, Australia
| | - Chris Van Vliet
- Department of Anatomical Pathology, 56375PathWest Laboratory Medicine WA, Nedlands, Australia
| | - Aws Jasim
- Department of Anatomical Pathology, 56375PathWest Laboratory Medicine WA, Nedlands, Australia
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Lin J, Kong J, Luo M, Shen Z, Fang S, Hu J, Xu Z, Dong W, Huang J, Lin T. Development and Validation of Survival Nomograms in Patients with Primary Bladder Lymphoma. J Clin Med 2022; 11:jcm11113188. [PMID: 35683570 PMCID: PMC9181374 DOI: 10.3390/jcm11113188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The existing studies on primary bladder lymphoma (PBL) are retrospective analyses based on individual cases or small series studies, and the research on PBL is not unified and in-depth enough at present because of the scarcity of PBL and the lack of relevant literature. This study is designed to develop and validate nomograms for overall survival (OS) and cancer-specific survival (CSS) prediction in patients with PBL. Methods: According to the Surveillance, Epidemiology, and End Results (SEER) database, 405 patients diagnosed with PBL from 1975 to 2016 were collected and randomly assigned to training (n = 283) and validation (n = 122) cohort. After the multivariable Cox regression, the OS and CSS nomograms were developed. The discrimination, calibration and clinical usefulness of the nomograms were assessed and validated, respectively, by the training and validation cohort. Furthermore, all of the patients were reclassified into high- and low-risk groups and their survival were compared through Kaplan-Meier method and log-rank test. Results: Age, subtype, Ann Arbor stage, radiation and chemotherapy were identified as independent prognostic factors for OS and age, sex, and subtype for CSS, then corresponding nomograms predicting the 3- and 5-year survival were constructed. The presented nomograms demonstrated good discrimination and calibration, which the C-index in the training and validation cohort were 0.744 (95% confidence interval [CI], 0.705–0.783) and 0.675 (95% CI, 0.603–0.747) for OS nomogram and 0.692 (95% CI, 0.632–0.752) and 0.646 (95% CI, 0.549–0.743) for CSS nomogram, respectively. Furthermore, the nomograms can be used to effectively distinguish Patients with PBL at high risk of death. The clinical usefulness of the nomograms was visually displayed by decision curve analysis. Conclusion: We updated the baseline characteristics of patients with PBL and constructed OS and CSS nomograms to predict their 3- and 5-year survival. Using these nomograms, it would be convenient to individually predict the prognosis of patients with PBL and provide guidance for clinical treatment.
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Affiliation(s)
- Junyi Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Jianbin Kong
- School of Medicine, Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen 518107, China;
| | - Mingli Luo
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Zefeng Shen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Shuogui Fang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China;
| | - Jintao Hu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Zixin Xu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Wen Dong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- Correspondence: (J.H.); (T.L.); Tel.: +86-13600054833 (J.H.); +86-13724008338 (T.L.); Fax: +86-020-81332603 (J.H.); +86-020-34070447 (T.L.)
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; (J.L.); (M.L.); (Z.S.); (J.H.); (Z.X.); (W.D.)
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- Correspondence: (J.H.); (T.L.); Tel.: +86-13600054833 (J.H.); +86-13724008338 (T.L.); Fax: +86-020-81332603 (J.H.); +86-020-34070447 (T.L.)
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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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Ishibashi N, Nakanishi Y, Nishimaki H, Maebayashi T, Masuda S, Okada M. Bladder mucosa-associated lymphoid tissue lymphoma progressed from chronic cystitis along with a comparative genetic analysis during long-term follow-up: a case report. Transl Androl Urol 2021; 10:3899-3906. [PMID: 34804832 PMCID: PMC8575576 DOI: 10.21037/tau-21-602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/12/2021] [Indexed: 12/12/2022] Open
Abstract
The pathogenesis of bladder marginal zone/mucosa-associated lymphoid tissue (MALT) lymphoma, which is the most common type of primary bladder lymphoma, has not been clarified. There are no reports that described histological and molecular time course of MALT lymphoma occurring in the bladder and the importance of the score on the Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale during and after radiation therapy (RT). We present a case of MALT lymphoma with long-term comparative genetic analysis. A 77-year-old Japanese woman with hematuria and severe perineal pain was found to have a tumor-like lesion in the bladder trigone. She was diagnosed with cystitis based on the results of pathological examination and immunostaining after transurethral resection of the lesion. The second transurethral resection procedure was performed approximately 4 years after the first procedure because of recurrence of the hematuria and enlargement of a lesion in the left bladder wall. Postoperative pathologic examination confirmed a diagnosis of MALT lymphoma. Genetic analysis of immunoglobulin heavy chain (IGH) gene rearrangements showed more clonal progression from the first biopsy to the second. The patient then underwent RT, during which her perineal pain was exacerbated by radiation cystitis but finally decreased to a level less severe than that before treatment. The PUF patient symptom scale was useful to monitor her pain throughout the clinical course. No recurrence was detected more than 2 years after completion of RT.
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Affiliation(s)
- Naoya Ishibashi
- Department of Radiology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Yoko Nakanishi
- Department of Oncologic Pathology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Haruna Nishimaki
- Department of Oncologic Pathology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Toshiya Maebayashi
- Department of Radiology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Shinobu Masuda
- Department of Oncologic Pathology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Masahiro Okada
- Department of Radiology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
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Vargas AC, Burchett I, Turner J, Delprado W, Brookwell R, Chalasani V, Gill AJ, Maclean FM. Monotypic Plasma Cell Proliferation of Uncertain Clinical Significance Mimicking Interstitial Cystitis: An Early Lesion of MALT Lymphoma? Am J Surg Pathol 2021; 45:841-853. [PMID: 33399339 DOI: 10.1097/pas.0000000000001659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We prospectively studied our institutional experience of bladder extranodal marginal zone (mucosa-associated lymphoid tissue [MALT]) lymphoma including bladder biopsies in which the possibility of MALT lymphoma was considered. We identified a subset of cases primary to the urinary bladder, presenting with prominent plasma cell infiltrates and symptoms mimicking bladder pain syndrome/interstitial cystitis. These proliferations were designated for this study as "monotypic plasma cell proliferation of uncertain clinical significance" (MPCP-US), as the features were insufficient for diagnosis of MALT lymphoma. We identified 33 patients, consisting of 22 cases of MPCP-US (6 of which were associated with amyloid deposition) and 11 cases of MALT lymphoma. MPCP-US was more prevalent in men (73%), a mass lesion was not identified at cystoscopy, and only 1 case had an accompanying urinary tract infection (4.5%). Histologically, MPCP-US presented as monotypic plasma cells arranged in a superficial band-like distribution in the lamina propria, predominantly kappa restricted (68%) and IgA+ or IgM+ (64% and 23%, respectively) and without a histologic mass of atypical B cells or plasma cells, not diagnostic for established MALT lymphoma or plasmacytoma. Secondary involvement of the bladder by other lymphoproliferative disorders was excluded and there was no evidence of progressive disease. MALT lymphomas are presented for comparison and our analysis demonstrated that MPCP-US represent a different clinicopathologic entity compared with classic MALT lymphoma. We present the first series of cases of MPCP-US. The recognition of this entity is fundamental to the development of management protocols to relieve intractable symptoms mimicking bladder pain syndrome/interstitial cystitis in these patients.
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MESH Headings
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biopsy
- Cell Proliferation
- Cystitis, Interstitial/pathology
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphoid Tissue/chemistry
- Lymphoid Tissue/pathology
- Lymphoma, B-Cell, Marginal Zone/chemistry
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Middle Aged
- Plasma Cells/chemistry
- Plasma Cells/pathology
- Predictive Value of Tests
- Prospective Studies
- Urinary Bladder/chemistry
- Urinary Bladder/pathology
- Urinary Bladder Neoplasms/chemistry
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- Ana Cristina Vargas
- Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital
- Faculty of Medicine, University of Sydney
| | - Ivan Burchett
- Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park
- School of Medicine, Notre Dame University
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW
| | - Jennifer Turner
- Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW
| | - Warick Delprado
- Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park
| | - Ross Brookwell
- Department of Cytogenetics, Sullivan Nicolades Pathology, Brisbane, QLD, Australia
| | | | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonard
- Faculty of Medicine, University of Sydney
| | - Fiona M Maclean
- Department of Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW
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Lyapichev KA, Ivashkevich Y, Chernov Y, Chinenov D, Shpot E, Bessonov AA, Dabaja BS, Konoplev S. MALT Lymphoma of the Urinary Bladder Shows a Dramatic Female Predominance, Uneven Geographic Distribution, and Possible Infectious Etiology. Res Rep Urol 2021; 13:49-62. [PMID: 33575225 PMCID: PMC7873029 DOI: 10.2147/rru.s283366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/11/2021] [Indexed: 12/22/2022] Open
Abstract
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the urinary bladder is an extremely rare entity accounting for 0.2% of all malignant urinary bladder neoplasms, and the diagnosis could be challenging. We present here a patient with urinary bladder MALT lymphoma and review of all published case reports in the literature. We summarized the reported immunophenotype of the neoplasm, ancillary studies, therapy, and follow-up for all 59 patients in the table. The median patients’ age was 57 years-old (range, 17 to 88), with female predominance in 50 of 59 patients representing a 1:5.6 ratio. Geographical distribution of the reported patients was as follows: 22 from Asia, of which more than a half (16) originated from Japan; 28 from Europe, of which 19 reported from the United Kingdom, and 3 patients were reported from the United States (including our patient). Twenty-three (77%) of 30 patients, for whom their clinical presentation was recorded, had symptoms of cystitis; Escherichia coli was the most common pathogen. We concluded that a prominent female predominance, uneven geographic distribution of urinary bladder MALT lymphoma, and a success of antibacterial therapy in selected cases suggest the link between urinary tract infection and urinary bladder MALT lymphoma.
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Affiliation(s)
- Kirill A Lyapichev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yana Ivashkevich
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yaroslav Chernov
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Denis Chinenov
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Evgeniy Shpot
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander A Bessonov
- Breast Cancer Department, NMRC N.N. Petrov Research Institute of Oncology of the Ministry of Healthcare, St. Petersburg, Russia
| | - Bouthaina S Dabaja
- Radiation Oncology Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergej Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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12
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Xu H, Chen Z, Shen B, Wei Z. Primary bladder mucosa-associated lymphoid tissue lymphoma: A case report and literature review. Medicine (Baltimore) 2020; 99:e20825. [PMID: 32664075 PMCID: PMC7360252 DOI: 10.1097/md.0000000000020825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 04/20/2020] [Accepted: 05/21/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Primary bladder mucosa-associated lymphoid tissue (MALT) lymphoma is a rare tumor. To date, the PubMed database contains only 39 English articles covering 63 cases of primary bladder MALT lymphoma. Herein, we report a case of this disease and review the current literature. PATIENT CONCERNS A 77-year-old woman presented with frequent urination, urinary urgency, and dysuria for 3 years. In the past 3 years, the patient's symptoms recurred and progressively worsened, and she was admitted to the hospital. DIAGNOSIS A histopathological examination revealed the bladder mass as a tumor with high proliferation of atypical B-lymphocytes. Immunohistochemistry showed positive results for CD20, PAX-5, Ki-67, BCL-2, and CD21 and negative results for CD10, MUM1, TDT, and cyclin D1. These data supported the diagnosis of primary bladder MALT lymphoma. INTERVENTIONS A transurethral resection of bladder tumor was performed to treat the disease. OUTCOMES The patient was alive and healthy at the 15-month follow-up. CONCLUSION Primary bladder MALT lymphoma is a rare disease and can be easily missed or misdiagnosed before achieving a histological confirmation. Surgery may be the best choice for both diagnosis and treatment.
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13
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Primary extra nodal Non-Hodgkin's lymphoma of urinary bladder presenting as a bladder tumor: A case report. Ann Med Surg (Lond) 2020; 56:68-71. [PMID: 32612819 PMCID: PMC7322174 DOI: 10.1016/j.amsu.2020.05.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Primary non-Hodgkin's lymphoma (NHL) of urinary bladder is an exceedingly rare entity accounting for 0.2% of the primary neoplastic lesions. This tumor has female predominance; with most of the cases seen in middle-aged females. It primarily affects urinary bladder without involvement of the surrounding tissues and lymph nodes. The common presentations include hematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. The clinical, radiological and endoscopic signs are not very specific. It is diagnosed by its characteristic morphology and immunohistochemical characteristics. The various therapeutic options available are chemotherapy; radiotherapy and surgery used either alone or in combination. Presentation of Case: We hereby report a case of 40 years old man who presented with hematuria as the presenting symptom. On radiology, diffuse thickening of bladder wall was noted, which was biopsied. On histopathology, it was NHL, Diffuse large B cell type. He was treated with chemotherapy (6 cycles of CHOP) and radiotherapy for primary NHL of the bladder and now he is in complete remission. Discussion Primary lymphoma of the urinary bladder is exceedingly rare. Non-specific presentation and rarity of this disease pose a diagnostic challenge for both the clinician and the histopathologist. Diagnosis is based upon the characteristic morphology and is supported by immunohistochemical analysis. Conclusion All patients with extra-nodal lymphoma need thorough diagnostic work up like nodal lymphomas to arrive at exact staging of the disease to outline subsequent management. Primary lymphomas of the urinary bladder are extremely rare. Non-specific presentation and rarity of this disease pose a diagnostic challenge for both the clinician and the histopathologist. Usually, the diagnosis is one of exclusion. It is made on biopsy with immunohistochemical study and after a negative study of disease extension.
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14
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Karaosmanoglu AD, Uysal A, Onur MR, Hahn PF, Ayhan AS, Ozmen MN, Akata D, Karcaaltincaba M. Primary lymphomas of the intraabdominal solid organs and the gastrointestinal tract: spectrum of imaging findings with histopathological confirmation. Abdom Radiol (NY) 2019; 44:2988-3005. [PMID: 31209544 DOI: 10.1007/s00261-019-02100-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Unlike nodal lymphoma, primary lymphomas of the intraabdominal organs are uncommon neoplasms whose diagnosis may be challenging in certain clinical circumstances. Despite this difficulty for imaging diagnosis, there are several imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography that may suggest the correct diagnosis. The scope of this review is to describe and illustrate the imaging features of primary lymphoma of intraabdominal organs providing clues to the diagnosis, together with their pathological correlations.
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15
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Sellman DP, Simpson WG, Klaassen Z, Jen RP, DiBianco JM, Reinstatler L, Li Q, Madi R, Terris MK. Characterization and outcomes of local treatment for primary bladder lymphoma: A population-based cohort analysis. Urol Ann 2018; 10:249-253. [PMID: 30089981 PMCID: PMC6060605 DOI: 10.4103/ua.ua_106_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Primary bladder lymphoma (PBL) is rare, representing 0.2% of extranodal lymphoma and less than 1% of all tumors originating in the bladder. Since the initial description of the disease, low-grade mucosa-associated lymphoid tissue (MALT) lymphoma has been reported as the most common subtype while high-grade disease was thought to represent only 20% of the reported cases. Materials and Methods: One hundred and ninety five patients with PBL from the Surveillance, Epidemiology, and End Results (SEER) registry from 1998-2010 were reviewed. Tumors were classified as high or low grade based on histologic subtype of lymphoma based on revised European-American Lymphoma classification system. Socio-demographic and clinical variables were reported, as well as survival outcome analyses using the Kaplan-Meier method and log-rank test. Cox proportional hazard analysis was used to generate hazard ratios for risk factors associated with mortality. Results: Eighty-three patients (42.6%) with low-grade and 112 patients (57.4%) with high-grade bladder lymphoma were studied. There were no differences between the low and high-grade groups for socio-demographic or clinical variables. Median overall survival or patients with low-grade disease was 38 months versus 15 months for patients with high-grade disease (p< 0.001). Analysis demonstrated worse survival outcomes for patients with high-grade disease compared to low-grade disease (p< 0.001). On multivariable analysis, increasing age and high-grade disease were associated with worse disease specific mortality (p< 0.001). Conclusion: Patient with high-grade primary bladder lymphoma had worse survival outcomes compared to those with low-grade disease. While transurethral resection provides tissue for diagnosis, immunotherapy/chemotherapy remains the mainstay of treatment for bladder lymphoma. Consolidation chemotherapy has been recommended in young patients not achieving complete remission with immunotherapy/chemotherapy.
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Affiliation(s)
- David P Sellman
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - W Greg Simpson
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Rita P Jen
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - John M DiBianco
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Lael Reinstatler
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Qiang Li
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Rabii Madi
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
| | - Martha K Terris
- Department of Surgery, Section of Urology, Medical College of Georgia - Augusta University, Augusta, Georgia, USA
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16
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Lontos K, Tsagianni A, Msaouel P, Appleman LJ, Nasioudis D. Primary Urinary Tract Lymphoma: Rare but Aggressive. Anticancer Res 2017; 37:6989-6995. [PMID: 29187485 PMCID: PMC5726395 DOI: 10.21873/anticanres.12167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/07/2017] [Accepted: 10/13/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Primary urinary tract lymphoma (PUTL) is an uncommon disease with only a few case reports in the literature. MATERIALS AND METHODS Information about 1,264 patients diagnosed between 1983 and 2013 with PUTL was extracted from the Surveillance, Epidemiology and End Results database. Kaplan-Meier curves and multivariable regression analysis were used to analyze the survival and identify prognostic factors. A comparison of nodal diffuse large B-cell lymphoma (DLBCL) with PUTL DLBCL was performed. In addition, we compared the characteristics of kidney and bladder lymphoma. RESULTS PUTL incidence was 1 case/1,000,000 people per year. DLBCL was found to be the predominant histology. Five-year overall survival and cancer-specific survival were 49% and 58%, respectively. DLBCL histology, male gender, stage III-IV disease, and advanced age were found to be poor prognostic factors. Surgery may be beneficial. Urinary tract DLBCL has a worse prognosis than nodal DLBCL. CONCLUSION To our knowledge, this is the largest population-based study of PUTL in the literature. The survival of patients has not improved in the era of modern therapies therefore new treatments are needed.
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Affiliation(s)
- Konstantinos Lontos
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
| | - Anastasia Tsagianni
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A
| | - Pavlos Msaouel
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A
| | - Leonard Joseph Appleman
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A
| | - Dimitrios Nasioudis
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, U.S.A
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17
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A case of mucosa-associated lymphoid tissue lymphoma of the bladder successfully treated with radiotherapy. Urol Case Rep 2017; 16:1-3. [PMID: 29021963 PMCID: PMC5633335 DOI: 10.1016/j.eucr.2017.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/21/2017] [Indexed: 11/04/2022] Open
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18
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Lobo J, Henrique R, Monteiro P, Lobo C. ALK-negative anaplastic large cell lymphoma with urinary bladder involvement diagnosed in urine cytology: A case report and literature review. Diagn Cytopathol 2017; 45:354-358. [PMID: 28139895 DOI: 10.1002/dc.23669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/29/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022]
Abstract
Anaplastic large cell lymphoma is an aggressive T-cell neoplasm. It rarely involves the urinary bladder, with just twelve cases reported thus far and only one being ALK-negative. Immunophenotyping (particularly for ALK) is mandatory, both for prognostic and therapeutic reasons. Herein, we report the case of a patient with an ALK-negative anaplastic large cell lymphoma involving the bladder which was diagnosed and fully characterized by immunocytochemistry in urine cytology. The patient underwent a cystoscopy and the urine sample disclosed tumor diathesis background and aggregates of atypical cells, with evidence of multinucleation and mitotic figures. Immunocytochemistry revealed strong membrane/Golgi positivity for CD30 and negativity for ALK. The patient was submitted to transurethral resection for therapeutic purposes, which confirmed the diagnosis. To the best of our knowledge, this represents only the third case of anaplastic large cell lymphoma with bladder involvement diagnosed in urine cytology and the very first with diagnostic findings allowing for immunophenotyping of the disease in a bladder wash. The present report reinforces the role of urine cytology as a suitable method for establishing an earlier diagnosis and characterization of the disease, avoiding submitting patients to invasive procedures like transurethral resections. Diagn. Cytopathol. 2017;45:354-358. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- João Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal.,Cancer Biology & Epigenetics Group - Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Portugal.,Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar - University of Porto (ICBAS-UP), Porto, Portugal
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal.,Cancer Biology & Epigenetics Group - Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Portugal.,Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar - University of Porto (ICBAS-UP), Porto, Portugal
| | - Paula Monteiro
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal.,Cancer Biology & Epigenetics Group - Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Portugal
| | - Cláudia Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
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19
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Vásquez Franco A, Franco A, Correa Galeano D, Hernández E, Aristizabal A. Linfoma B difuso de células grandes de la vejiga secundario. UROLOGÍA COLOMBIANA 2015. [DOI: 10.1016/j.uroco.2015.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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MALT Lymphoma of the Bladder: A Case Report and Review of the Literature. Case Rep Hematol 2015; 2015:934374. [PMID: 26417464 PMCID: PMC4568333 DOI: 10.1155/2015/934374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/12/2015] [Indexed: 12/20/2022] Open
Abstract
The presentation of a MALT lymphoma in the bladder is exceedingly rare. Furthermore, the optimal treatment of primary MALT confined to the bladder remains to be defined. Here, we report a case of a 65-year-old female with primary MALT lymphoma treated with definitive radiation therapy. The patient received a total dose of 30 Gy in 20 equal daily fractions to the bladder and tolerated the treatment well. In addition, we have extensively reviewed the relevant literature to better define the optimal management of this rare disease. In conclusion, primary MALT lymphoma of the bladder represents a rare malignancy with excellent prognosis if detected at an early stage. For early stage disease, definitive radiation represents an excellent treatment modality with a minimal side-effect profile.
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21
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Pseudocarcinomatous hyperplasia associated with primary lymphoma in the urinary bladder: a case report. Hum Pathol 2015; 46:1040-4. [DOI: 10.1016/j.humpath.2015.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/04/2015] [Accepted: 03/02/2015] [Indexed: 12/26/2022]
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22
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Liang X, Wang Y, Zhang J, Cheng H, Wang J, Dang Y, Li H, Zhou R, Zhang J, Qiao Q. Anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma with involvement of the urinary bladder: a case report and review of literature. Onco Targets Ther 2015; 8:1143-7. [PMID: 26056479 PMCID: PMC4446009 DOI: 10.2147/ott.s77297] [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] [Indexed: 11/23/2022] Open
Abstract
We report a unique case of anaplastic large-cell lymphoma (ALCL) involving the urinary bladder in a 22-year-old man. The patient presented with left lower back pain for 4 weeks. The computed tomography (CT) scan demonstrated an exophytic nodule on the left bladder wall and abdominopelvic lymphadenopathy. Histologically, a population of large pleomorphic cells extensively infiltrated the lamina propria of the bladder. These cells were diffusely and strongly immunoreactive for CD30, ALK, EMA, and vimentin, but were negative for AE1/AE3, CK20, CK7, CK5/6, P63, SMA, HMB-45, pan-Melan, S-100, Myo D1, synaptophysin, CD56, desmin, CD15, CD20, Pax-5, and CD3. Few cells exhibited positive immunohistochemical staining of CD45. The patient underwent cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regime of chemotherapy and achieved a complete remission after four cycles. This case is the tenth documented case of systemic ALCL involving urinary bladder. Due to its rarity, it is important to be aware of the features of ALCL in bladder, and make prompt and accurate diagnosis.
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Affiliation(s)
- Xiaoqin Liang
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China ; Department of Pathology, Gansu Provincial People's Hospital, Lanzhou, Gansu, People's Republic of China
| | - Yingmei Wang
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jinsong Zhang
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Hong Cheng
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jinsui Wang
- Department of Pathology, Gansu Provincial People's Hospital, Lanzhou, Gansu, People's Republic of China
| | - Yamei Dang
- Department of Pathology, Gansu Provincial People's Hospital, Lanzhou, Gansu, People's Republic of China
| | - Haomin Li
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China ; Department of Neurosurgery, First affiliated Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Ru Zhou
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jing Zhang
- State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Qing Qiao
- Department of General Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
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Simpson WG, Lopez A, Babbar P, Payne LF. Primary bladder lymphoma, diffuse large B-cell type: Case report and literature review of 26 cases. Urol Ann 2015; 7:268-72. [PMID: 25837971 PMCID: PMC4374275 DOI: 10.4103/0974-7796.152947] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 06/24/2014] [Indexed: 02/06/2023] Open
Abstract
Primary lymphoma of the urinary bladder is exceedingly rare, representing 0.2% of all extranodal non-Hodgkin's lymphoma. Although Matsuno et al. and others state the most common type is mucosa-associated lymphoid tissue (MALT) lymphoma, 20% of all the primary lymphomas of the urinary bladder are considered to be high grade neoplasms; the majority being diffuse large B-cell lymphoma (DLBCL). This is a case report of a 48-year-old man that presented with hematuria, frequency, nocturia, and flank pain that was found to have high grade DLBCL. Twenty-six other cases of both low and high grade primary bladder lymphomas were selected in order to provide a thorough comparison of different treatment modalities. Of the cases reviewed, bladder lymphoma was more common in females (2:1). The average age at diagnosis was 63.9 years old (low grade: 68.7 years old, high grade: 58.8 years old). The most common low-grade neoplasm was MALT lymphoma (85.7%). For the low-grade malignancies, the most successful treatments were simple therapies (2 transurethral resection of a bladder tumour [TURBT], 1 antibiotics), solitary chemotherapy, and combination TURBT/chemo; all 3 of which achieved 100% clinical remission (CR) in the cases reviewed. The most common high grade neoplasm was DLBCL (76.9%). The most successful therapies used to treat high grade lesions were solitary chemotherapy (cyclophosphamide, duanorubacin, vincristine, prednisolone [CHOP] or ritoximab, CHOP [R-CHOP]) and combination therapies (2 radiation/CHOP, 2 surgery/CHOP). In the agreement with the current literature, this review has shown that simple therapies (TURBT) are equally as effective as aggressive treatments (chemotherapy, radiation) and should therefore be used as first line treatment in low grade tumors. For high grade malignancies, chemotherapy (R-CHOP or CHOP) alone or combination therapy (CHOP/surgery or CHOP/radiation) is recommended.
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Affiliation(s)
- W Greg Simpson
- Department of Urology, West Virginia School of Osteopathic Medicine, Lewisburg, WV 24901, USA
| | - Armando Lopez
- Department of Urology, Raleigh General Hospital, Beckley, WV 28051, USA
| | - Paurush Babbar
- Department of Urology, Glickman Urological and Kidney Institute Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Chen H, Li Y, Nand S, Quek ML, Kini AR, Barkan GA. Anaplastic large cell lymphoma involving the urinary bladder: a case report and review of the literature. Diagn Cytopathol 2014; 43:60-5. [PMID: 24623571 DOI: 10.1002/dc.23126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 12/12/2013] [Accepted: 01/16/2014] [Indexed: 12/18/2022]
Abstract
T cell-derived malignant lymphoma is rarely detected as a bladder neoplasm. A literature review for anaplastic large cell lymphoma (ALCL) involving urinary bladder reveals only seven previously reported cases. Here, we report a case of a 59-year-old HIV-negative man with ALK-positive ALCL. He presented an unusual clinical course with initial consideration of adult onset Still's Disease (AOSD) due to his negative results searching for malignancy and infectious diseases. He rapidly developed macrophage activation (hemophagocytic) syndrome and experienced an unusual rapid disease progression and died in 39 days after onset of symptoms. Compared to previously reported cases, the current case of ALK-1-positive ALCL is a rare case with an unusual presentation. From this case, we learned that ALCL is one malignancy that should be considered and screened in patients with suspected AOSD. Also, T-cell lymphoma associated hemophagocytic syndrome should be considered in a patient with sustained corticosteroid-resistant spike fever, high serum ferritin, and rapid exacerbation of the disease course.
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Affiliation(s)
- Haiyan Chen
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
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25
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Lucioni M, Nicola M, Riboni R, Croci GA, Rattotti S, Gotti M, Arcaini L, Paulli M, Cristina S, Valentini S, Martinengo C. Antibiotic therapy-induced remission of bladder mucosa-associated lymphoid tissue (MALT) lymphoma carrying t(11;18)(q21;q21) apoptosis inhibitor 2-MALT1. J Clin Oncol 2013; 31:e304-6. [PMID: 23690413 DOI: 10.1200/jco.2012.46.4800] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Marco Lucioni
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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26
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Lawrenz J, Tomal J, Towne J, Johnson B, Rieger B. ALK+ Anaplastic Large Cell Lymphoma With Bladder Involvement Presenting as Fever of Unknown Origin: A Case Report and Literature Review. World J Oncol 2013; 4:95-101. [PMID: 29147338 PMCID: PMC5649675 DOI: 10.4021/wjon644w] [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] [Accepted: 04/04/2013] [Indexed: 11/23/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare malignant tumor normally originating in lymph nodes, though it can occur in extranodal sites. We report a 59-year-old man with anaplastic lymphoma kinase (ALK) positive ALCL involving the bladder diagnosed post-mortem who presented with fever of unknown origin. This is the seventh reported case of ALCL presenting as a bladder neoplasm. The patient presented to his primary care physician with a several day history of fever. An eventual computed tomography scan of the abdomen and pelvis showed widespread adenopathy in the pelvis and retroperitoneum. After a negative infectious investigation, the patient underwent exploratory laparotomy with excisional biopsy of periaortic lymph nodes. Pathology revealed reactive lymphocytes. Bone marrow biopsy also was negative for malignancy. The patient’s fevers persisted, and he later exhibited dysuria and hematuria with evidence of bilateral hydronephrosis. Cystoscopy revealed an erythematous, diffusely friable bladder mucosa with inaccessible ureteral orifices, and biopsies were taken. The patient continued to deteriorate clinically because of associated macrophage activation syndrome, a close variant of hemophagocytic lymphohistiocytosis, and expired the following day. Autopsy was declined. Post-mortem pathology reports from cystoscopy revealed ALK+ ALCL of the bladder.
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Affiliation(s)
- Joshua Lawrenz
- Division of General Internal Medicine, Department of Medicine, Loyola University Medical Center, 2160 S. First Ave. Maywood, IL 60153, USA
| | - Justin Tomal
- Division of General Internal Medicine, Department of Medicine, Loyola University Medical Center, 2160 S. First Ave. Maywood, IL 60153, USA
| | - James Towne
- Division of General Internal Medicine, Department of Medicine, Loyola University Medical Center, 2160 S. First Ave. Maywood, IL 60153, USA
| | - Beth Johnson
- Department of Pathology, Central DuPage Hospital of Cadence Health, 25 N. Winfield Rd. Winfield, IL 60190, USA
| | - Brent Rieger
- Division of General Internal Medicine, Department of Medicine, Loyola University Medical Center, 2160 S. First Ave. Maywood, IL 60153, USA
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Matsuoka T, Yoshino T, Fukuhara Y, Miyanaga N, Oka K, Nagayama R, Sekido N, Maebayashi K. Mucosa-associated lymphoid tissue lymphoma of the urinary bladder. Int Cancer Conf J 2012. [DOI: 10.1007/s13691-012-0041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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28
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Affiliation(s)
- Michael H Johnson
- Department of Surgery/Division of Urology, Washington University School of Medicine, St Louis, Missouri, USA
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29
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Wang L, Cao ZZ, Qi L. Primary T-cell lymphoma of the urinary bladder presenting with haematuria and hydroureteronephrosis. J Int Med Res 2012; 39:2027-32. [PMID: 22118008 DOI: 10.1177/147323001103900550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Primary bladder lymphoma, a rare form of non-Hodgkin's lymphoma that is confined to the urinary bladder, is usually of B-cell origin. This report describes an extremely rare case of primary T-cell lymphoma of the urinary bladder. A 45-year-old man presented with haematuria, dysuria and loin pain. Ultrasonography and computed tomography showed a thickened left bladder wall and left hydroureteronephrosis. A diagnosis of primary T-cell lymphoma of the urinary bladder was made on the basis of clinical, radiological and histological findings. The patient, following transurethral resection, was treated with four cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy with a good response and remains in clinical remission 12 months after treatment.
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Affiliation(s)
- L Wang
- Department of Urology, Xiangya Hospital, Changsha, China
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30
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Primary MALT lymphoma of the urinary bladder in the background of interstitial cystitis. Ann Hematol 2012; 91:1505-6. [DOI: 10.1007/s00277-012-1419-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 01/23/2012] [Indexed: 01/31/2023]
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Abstract
PURPOSE OF REVIEW Urothelial carcinoma is the most common histological type of bladder tumours. Nevertheless, its variants and less common types represent 20% of all bladder cancers. The objective was to update the recent publications on these rare diseases and to draw conclusions for clinical management. RECENT FINDINGS Recent retrospective studies have been published. They refine the description of histological patterns and of immunochemistry diagnosis. Taking into account the heterogeneity of these pathologies, several groups have benefited of increased knowledge such as sarcomas and lymphomas. The need of international collaboration to study prospectively some subgroups of tumours is crucial. SUMMARY Rare bladder cancers have generally poor outcome and in a majority of the cases surgery, namely cystectomy remains the most important curative treatment. Specific subgroups, as lymphoma, sarcoma and dedifferentiated epithelial tumours may benefit of molecular characterization and trials with targeted drugs.
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32
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Terada T. Primary CD5-positive mucosa-associated lymphoid tissue lymphoma of the urinary bladder. Ann Diagn Pathol 2011; 15:382-4. [DOI: 10.1016/j.anndiagpath.2011.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 02/23/2011] [Indexed: 11/26/2022]
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33
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Szopiński TR, Sudoł-Szopińska I, Dzik T, Borówka A, Dembowska-Bagińska B, Perek D. Incidental sonographic detection of mucosa-associated lymphoid tissue lymphoma of the urinary bladder found in a very young woman: report of a case. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:233-235. [PMID: 21480290 DOI: 10.1002/jcu.20786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 08/06/2010] [Accepted: 10/22/2010] [Indexed: 05/30/2023]
Abstract
We report a rare case of a mucosa-associated lymphoid tissue (MALT)-type lymphoma of the bladder, incidentally found on sonography in a 17-year-old girl during the workup of arterial hypertension. The diagnosis was established by a transurethral biopsy. Treatment consisted of transurethral resection of the bladder tumor and subsequent chemotherapy. To the best of our knowledge, this is the youngest patient with asymptomatic MALT-type lymphoma of the urinary bladder.
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Affiliation(s)
- Tomasz R Szopiński
- Department of Urology, Postgraduate Medical Education Center, Warsaw, Poland
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34
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Hui D, Proctor B, Donaldson J, Shenkier T, Hoskins P, Klasa R, Savage K, Chhanabhai M, Gascoyne RD, Connors JM, Sehn LH. Prognostic implications of extranodal involvement in patients with diffuse large B-cell lymphoma treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone. Leuk Lymphoma 2010; 51:1658-67. [DOI: 10.3109/10428194.2010.504872] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Bladder tumours are frequent with around 10,000 new cases each year in France. Less than 500 of these cases are not transitional cell carcinoma, the most frequent pathological aspect. The identification of these pathological patterns requires an initial biopsy through transurethral resection. Sarcomatoid, squamous and some adenocarcinomatous types are often pathological variants of the transitional pattern. These tumours are possibly secondary to alkylating drug metabolites or pelvic radiotherapy and they have often a poor prognostic outcome. This is also the case of spindle cell carcinoma, an endocrine variant of rare bladder cancers. The treatment is generally based on an aggressive approach combining chemotherapy and a radical cystectomy. Other tumours have a more locally invasive pattern, as have urachal adenocarcinomas, sarcomas. The treatment is based on aggressive surgical exeresis of the tumour and surrounding structures. The outcome may be more favourable. Primary non Hodgkin lymphomas are rare, secondary involvement more frequent. All histological subtypes could be encountered. The treatment is the same as this of lymphomas of other location and of the same histology. Attention must be drawn on a precise evaluation of the pathological pattern and of the disease extension.
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36
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Schniederjan SD, Osunkoya AO. Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases. Mod Pathol 2009; 22:1057-65. [PMID: 19377442 DOI: 10.1038/modpathol.2009.65] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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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37
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Kim SK, Kim MH, Lee N, Cha D, Kim H, Choi YJ, Chung JS, Cho GJ. Primary Diffuse Large B Cell Lymphoma of the Bladder. THE KOREAN JOURNAL OF HEMATOLOGY 2009. [DOI: 10.5045/kjh.2009.44.2.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Seon Kyeong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Naria Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Donghyuk Cha
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hyojeong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Young Jin Choi
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Joo Seop Chung
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Goon Jae Cho
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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38
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Rhabdomyosarcoma of the Urinary Bladder in Adults: Predilection for Alveolar Morphology With Anaplasia and Significant Morphologic Overlap With Small Cell Carcinoma. Am J Surg Pathol 2008; 32:1022-8. [DOI: 10.1097/pas.0b013e3181650e4a] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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39
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Primary non-hodgkin lymphoma of urinary bladder with nine years later renal involvement and absence of systemic lymphoma: a case report. Med Oncol 2007; 25:248-50. [PMID: 18040901 DOI: 10.1007/s12032-007-9025-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Accepted: 10/20/2007] [Indexed: 10/22/2022]
Abstract
AIMS Primary bladder non-Hodgkin lymphoma (PBNHL) is very rare, especially as extranodal B-small lymphocytic lymphoma (B-SLL). Also, late isolated renal manifestation of PBNHL is extremely unusual. We report a very rare type of extranodal B-SLL of bladder wall with extremely unusual late isolated renal involvement, clinically manifested by nephrotic syndrome and incipient renal failure. A CASE REPORT A 56-year-old woman was presented with a solitary tumor of bladder wall, with history of dysuria and night sweating. A transvaginal needle biopsy of the tumor was performed, and diagnosis of primary extranodal B-SLL was made in the absence of bone marrow, lymph node, or blood involvement. She was treated with chemotherapy until the achievement of complete remission. Nine years later, she developed nephrotic syndrome. The renal biopsy revealed parenchymal lymphoma's involvement associated with glomerular lesion. Immunohistochemical analysis confirmed the same imunophenotype of lymphoma cells like in bladder wall nine years ago. Restaging procedure showed no evidence of disease elsewhere. CONCLUSION To our knowledge, it is the first case of association of very rare primary bladder B-SLL with late isolated renal involvement.
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