Long standing priapism as presentation of lymphoma

Priapism in Lymphoproliferative Disorders: A Systematic Review

Priapism is defined as a persistent penile erection lasting more than 4 h. We searched the literature for reviews, case reports, and series for patients with lymphoproliferative disorders who developed priapism. The search involved all the lymphoproliferative disorders included in the revised 2016 World Health Organization classification of lymphoid neoplasms including chronic lymphocytic leukemia, multiple myeloma, Waldenström macroglobulinemia, and lymphomas. A total of 16 articles were found. The search included cases up to 4^th January 2021. Priapism was seen most commonly as the first manifestation of lymphoproliferative disorders, rarely seen after treatment or after diagnosis.

Priapism as the initial symptom of primary penile lymphoma: A case report

Primary penile lymphoma presenting with priapism as the initial symptom is extremely rare. In total, <10 cases have been previously reported. The diagnosis can be difficult and patients often develop metastasis. The current study reports the case of a 48-year-old male, who presented with a one-month history of painless priapism. On admission to Yantai Yuhuangding Hospital Affiliated to Qingdao University (Yantai, China), examination revealed an erect penis, enlarged lymph nodes in the bilateral inguinal and swelling in the thighs. A biopsy was taken from the right inguinal lymph node and the pathological diagnosis confirmed a diffuse large B-cell type of non-Hodgkin's lymphoma, while an enhanced computed tomography scan of the chest revealed evidence of the invasion of malignant lymphoma cells. Priapism disappeared two days following the completion of the first cycle of chemotherapy with the E-CHOP regimen (cyclophosphamide, vincristine, prednisone, epirubicin and etoposide); however, evidence of brain metastases was observed one month later, which was confirmed by magnetic resonance imaging. The patient received cranial radiotheraphy and systemic treatment for cerebral edema. The patient did not respond well to treatment and succumbed to the disease three months following the initial diagnosis of lymphoma. Lymphoma may be difficult to diagnose, depending on the initial symptoms; therefore, the patient history must be carefully assessed so as to determine an early diagnosis and prevent metastasis, thus improving the prognostic outcome.

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.