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Dominic JL, Ganduboina R, Dutta P, Gubran K, Toussaint ML, Isrow DM. Primary bladder B-cell lymphoma: a rare case report and review of literature. Ann Med Surg (Lond) 2024; 86:3652-3657. [PMID: 38846862 PMCID: PMC11152792 DOI: 10.1097/ms9.0000000000002051] [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: 02/09/2024] [Accepted: 03/28/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction and importance Primary bladder lymphoma accounts for a mere fraction of vesical tumours and extranodal lymphomas, which mostly affect women. IGH-BCL2 translocation, which occurs in 80-100% of Western follicular variants but only 60% in Asian communities, must be studied to determine its effects on prognosis and treatment. This study analyses and compares relevant literature and data for the authors' case report. Case presentation The authors report a 69-year-old Caucasian female with one gross haematuria episode and no smoking history. Computed tomography (CT) showed a bilateral massive intraluminal mass left ureterovesical junction, hydronephrosis, and hydroureter. Clinical discussion Following the removal of a massive transurethral urinary bladder tumour, histological examination revealed lymphoma cells positive for IRTA and LMO2 but negative for IGH-BCL2. After these analyses, the patient received 3 weeks of 30 Gy/15 f IMRT/IGRT. Comparisons were made to previous case reports' histopathology. Conclusion The current case report emphasizes the rarity of primary bladder lymphoma and the absence of the IGH-BCL2 fusion gene. Following the successful administration of 30 Gy of radiation therapy, the patient's prognosis improved. The report emphasizes clinical vigilance and timely management while also urging further investigation.
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Affiliation(s)
- Jerry Lorren Dominic
- Department of General Surgery, University of Miami Miller School of Medicine/Jackson Memorial Hospital
| | | | | | | | | | - Derek Michael Isrow
- Radiation Oncology, University of Miami/Jackson Memorial Hospital & Sylvester Cancer Center, Miami, FL
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2
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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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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: 0] [Impact Index Per Article: 0] [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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4
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Katano A, Yamashita H. Primary urinary bladder marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. J Cancer Res Ther 2022; 18:1814-1816. [DOI: 10.4103/jcrt.jcrt_238_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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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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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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Grilo I, Rodrigues C, Soares A, Grande E. Facing treatment of non-urothelial bladder cancers in the immunotherapy era. Crit Rev Oncol Hematol 2020; 153:103034. [PMID: 32622321 DOI: 10.1016/j.critrevonc.2020.103034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022] Open
Abstract
Non-urothelial Bladder Cancer (BC) and variants of urothelial carcinoma account for up to 25 % of all BCs. Given their heterogeneity, these entities are not well represented in clinical trials and treatment remains challenging. Checkpoint inhibitor therapy has shown a role in the treatment of urothelial BC. By contrast, robust evidence regarding its use in other histological types is lacking. We aimed to provide a comprehensive update of non-urothelial and variant urothelial BC, exploring the evidence for immune checkpoint inhibitor therapy. A detailed analysis of the literature was conducted regarding epidemiology, aetiology, diagnosis, prognosis, treatment and outcomes of these patients in the immunotherapy era. A growing body of evidence suggests that immune checkpoint inhibition might have a role to play in non-urothelial BC, similarly to what happened with urothelial carcinomas.
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Affiliation(s)
- I Grilo
- Medical Oncology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - C Rodrigues
- Medical Oncology Department, Centro Hospitalar de Entre o Douro e Vouga, EPE, Sta Maria da Feira, Portugal
| | - A Soares
- Medical Oncology Department, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - E Grande
- Medical Oncology Department, MD Anderson Cancer Center Madrid, Madrid, Spain.
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Kadam PD, Han HC, Kwok JL. An uncommon case of mucosa-associated lymphoid tissue (MALT) tumor of the bladder. Int Urogynecol J 2018; 30:1017-1018. [DOI: 10.1007/s00192-018-3813-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 11/02/2018] [Indexed: 01/14/2023]
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11
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Alanee S, Alvarado-Cabrero I, Murugan P, Kumar R, Nepple KG, Paner GP, Patel MI, Raspollini MR, Lopez-Beltran A, Konety BR. Update of the International Consultation on Urological Diseases on bladder cancer 2018: non-urothelial cancers of the urinary bladder. World J Urol 2018; 37:107-114. [PMID: 30069580 DOI: 10.1007/s00345-018-2421-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/23/2018] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To provide a comprehensive update of the joint consultation of the International Consultation on Urological Diseases (ICUD) for the diagnosis and management of non-urothelial cancer of the urinary bladder. METHODS A detailed analysis of the literature was conducted reporting on the epidemiology, etiology, diagnosis, treatment and outcomes of non-urothelial cancer of the urinary bladder. An international, multidisciplinary expert committee evaluated and graded the evidence according to the Oxford System of Evidence-based Medicine modified by the ICUD. RESULTS The major non-urothelial cancers of the urinary bladder are squamous cell carcinoma, adenocarcinoma, and neuroendocrine tumors. Several other non-urothelial tumors are rare but important to identify because of their aggressive behavior when compared to urothelial bladder tumors. Radical cystectomy and urinary diversion, preceded by neoadjuvant radiation or chemotherapy in some of these tumors, is the main method or treatment for resectable disease. Adjuvant therapy is not usually successful and no novel targeted or immunotherapeutic agents have been identified to provide benefit. Patients with small cell neuroendocrine tumors of the bladder should be offered chemotherapy before surgery. Because non-urothelial cancers are usually locally advanced and/or metastatic at the time of diagnosis, 5-year survival is generally poor. CONCLUSIONS Non-urothelial cancers of the urinary bladder are rare and mostly lack established protocols for treatment. The prognosis of most of these tumors is poor because they are usually advanced at the time of diagnosis. A multimodal treatment approach should be considered to improve outcomes.
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Affiliation(s)
- Shaheen Alanee
- Urologic Oncology, Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.
| | | | - Paari Murugan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Rajeev Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | - Kenneth G Nepple
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Gladell P Paner
- Departments of Pathology and Surgery (Urology), University of Chicago, Chicago, IL, USA
| | - Manish I Patel
- Department of Urology, Westmead Hospital and Discipline of Surgery, University of Sydney, Sydney, Australia
| | | | | | - Badrinath R Konety
- Department of Urologic Surgery, University of Minnesota, Minneapolis, MN, USA
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12
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Clinical characteristics and outcomes of nonurothelial cell carcinoma of the bladder: Results from the National Cancer Data Base. Urol Oncol 2018; 36:78.e1-78.e12. [DOI: 10.1016/j.urolonc.2017.10.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/02/2017] [Accepted: 10/13/2017] [Indexed: 11/21/2022]
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Abstract
Urinary bladder lymphomas are rare lesions which may be primary bladder lymphomas or part of systemic lymphoma with bladder involvement. We report a case of non-Hodgkin's lymphoma (NHL) in a 73-year-old female who presented with bladder tumor which on evaluation revealed NHL with extensive systemic involvement. The management of such an advanced case is discussed here with literature review.
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Affiliation(s)
- Naveen Kumar Gupta
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Dilip Kumar Pal
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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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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15
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Lala S, Shehata AM, Al Busaidy SS, Alozeni AA, Bhatnagar G. Primary lymphoma of the urinary bladder: A case report. JOURNAL OF CLINICAL UROLOGY 2014. [DOI: 10.1177/2051415814557068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a rare case of primary non-Hodgkin’s B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type occurring in the urinary bladder. A 70-year-old woman presented with gross haematuria, and an abdominal CT scan revealed a bladder tumour which was resected endoscopically. Histopathological diagnosis was confirmed by immunohistochemical staining and treated successfully with radiotherapy.
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Affiliation(s)
- Sadiq Lala
- Department of Urology, Royal Hospital, Sultanate of Oman
| | - Adel M Shehata
- Department of Urology, Royal Hospital, Sultanate of Oman
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16
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Lymphoma of the urinary bladder. Adv Urol 2014; 2014:327917. [PMID: 24511310 PMCID: PMC3912819 DOI: 10.1155/2014/327917] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 10/02/2013] [Accepted: 10/08/2013] [Indexed: 12/27/2022] Open
Abstract
Background. Lymphoma of the urinary bladder (LUB) is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18)(q21: 21). Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.
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17
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Mahfoud T, Tanz R, Mesmoudi M, Khmamouche MR, El Khannoussi B, Ichou M, Errihani H. Primary non-Hodgkin's lymphoma of the bladder: case report and literature review. Pan Afr Med J 2013; 15:136. [PMID: 24319526 PMCID: PMC3852514 DOI: 10.11604/pamj.2013.15.136.1599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 07/19/2012] [Indexed: 11/11/2022] Open
Abstract
Primary non-Hodgkin's lymphoma (NHL) of the bladder is a very rare entity. The clinical, radiological and endoscopic signs are not specifics. The diagnosis is exclusively histological. Chemotherapy, radiotherapy and surgery are the different therapeutic options used either alone or in combination. We report a 57 years old patient treated with chemotherapy (6 cycles of R-CHOP) for primary NHL of the bladder with a complete response while discussing the different specificities of this disease.
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Affiliation(s)
- Tarik Mahfoud
- Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco
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18
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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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19
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Takahashi H, Shimazaki H, Oda T, Endo H, Sekitsuka H, Maekawa K, Katsurada Y, Sato K, Ito K, Nakanishi K, Tamai S. Malignant lymphoma case with urinary cytology mimicking that of urothelial carcinoma. Cytopathology 2012; 24:412-4. [DOI: 10.1111/cyt.12026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Schlager T, LeGallo R, Innes D, Hendley J, Peters C. B Cell Infiltration and Lymphonodular Hyperplasia in Bladder Submucosa of Patients With Persistent Bacteriuria and Recurrent Urinary Tract Infections. J Urol 2011; 186:2359-64. [DOI: 10.1016/j.juro.2011.07.114] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Indexed: 10/16/2022]
Affiliation(s)
- T.A. Schlager
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
- Department of Emergency Medicine, University of Virginia, Charlottesville, Virginia
| | - Robin LeGallo
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - D. Innes
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - J.O. Hendley
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - C.A. Peters
- Department of Urology, University of Virginia, Charlottesville, Virginia
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21
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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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22
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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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23
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Ploeg M, Aben KK, Hulsbergen-van de Kaa CA, Schoenberg MP, Witjes JA, Kiemeney LA. Clinical epidemiology of nonurothelial bladder cancer: analysis of the Netherlands Cancer Registry. J Urol 2010; 183:915-20. [PMID: 20083267 DOI: 10.1016/j.juro.2009.11.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE Nonurothelial malignancies represent a small fraction of bladder malignancies and are less extensively studied, resulting in sparse empirical data on these tumors. We sought insight into tumor characteristics and survival. MATERIALS AND METHODS Data were obtained from the nationwide Netherlands Cancer Registry on patient and tumor characteristics, and followup in all patients with primary invasive (T1 or greater) bladder tumors in The Netherlands between 1995 and 2006. Data were analyzed using frequency tables. Relative survival analysis was done. RESULTS We identified 28,807 patients with invasive bladder cancer, of whom 7.7% presented with nonurothelial carcinoma. Mean patient age range at diagnosis of adenocarcinoma and soft tissue tumors was 66.4 years, and 78.3 years at diagnosis of nonspecified tumors. Most histological subtypes were more common in males except squamous cell carcinoma and lymphoma. Muscle invasion was seen in 52.2% of urothelial carcinoma cases vs 87.5%, 71.9% and 89.0% of squamous cell carcinoma, adenocarcinoma and neuroendocrine tumor cases, respectively. For urothelial carcinoma, squamous cell carcinoma and adenocarcinoma women presented at more advanced stage. In the neuroendocrine group this stage difference was the opposite. Survival analysis showed a 5-year relative survival rate of 32.2%, 22.9%, 31.8% and 21.1% for T2 or greater urothelial carcinoma, squamous cell carcinoma, adenocarcinoma and neuroendocrine tumors, respectively. CONCLUSIONS Patients with nonurothelial carcinoma present at more advanced stage and overall have worse survival. Relative survival of muscle invasive adenocarcinoma equals survival of muscle invasive urothelial carcinoma. For stage II and III disease these cases do even better. Muscle invasive squamous cell carcinoma and neuroendocrine tumors show worse survival regardless of stage.
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Affiliation(s)
- Martine Ploeg
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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24
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Hughes M, Morrison A, Jackson R. Primary bladder lymphoma: management and outcome of 12 patients with a review of the literature. Leuk Lymphoma 2009; 46:873-7. [PMID: 16019532 DOI: 10.1080/10428190500079829] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Primary bladder non-Hodgkin's lymphoma (NHL) is rare. Optimal management remains controversial. Using the Scotland and Newcastle lymphoma group database, 12 patients with primary bladder lymphoma were identified between 1980 and 2001, the largest single group of patients available to date. Histology and immunocytochemistry was reviewed in 9 of the 12 cases. Six cases were low-grade extranodal marginal zone lymphoma, 4 diffuse large B-cell lymphoma, one an ALK 1 positive anaplastic large cell lymphoma (ALKoma) and one a low-grade lymphoma unspecified. Two patients (low-grade NHL) were treated with oral antibiotics (n=1) or diathermy (n=1) alone with complete resolution of disease. One patient with high-grade NHL gained complete remission without conventional therapy. Nine patients were treated with single or combined modality surgery, chemotherapy and/or radiotherapy. Overall survival was 75%, mean follow up of 4.8 (range 1-10) years. A review of 88 additional cases in the literature support the findings that primary bladder lymphoma is associated with a good prognosis. Patients with low-grade extranodal marginal zone lymphoma may respond well to simple therapies. Patients with diffuse large B-cell lymphoma respond well to first-line chemotherapy regimens. Ureteric obstruction and acute renal failure are serious complications. Repeat cystoscopy is mandatory for follow-up.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/therapy
- Male
- Medical Oncology/methods
- Prognosis
- Registries
- Remission Induction
- Treatment Outcome
- Urinary Bladder Neoplasms/diagnosis
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/therapy
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Affiliation(s)
- Marie Hughes
- Department of Haematology, Western Infirmary, Glasgow, UK.
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25
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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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26
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Carver JD, Calverley D, Shen P. Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting in urinary bladder without peripheral blood lymphocytosis: Case report and literature review. Leuk Lymphoma 2009; 47:1163-5. [PMID: 16840214 DOI: 10.1080/10428190500465283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Lau SK. Cytomorphologic features of the plasmacytoid variant of urothelial carcinoma: A case report. Diagn Cytopathol 2009; 37:359-64. [DOI: 10.1002/dc.21015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Chua SC, Rozalli FI, O'Connor SR. Imaging features of primary extranodal lymphomas. Clin Radiol 2008; 64:574-88. [PMID: 19414080 DOI: 10.1016/j.crad.2008.11.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 10/18/2008] [Accepted: 11/02/2008] [Indexed: 12/14/2022]
Abstract
Lymphomas are generally considered tumours of lymph nodes, but up to 40% arise extranodally. This group shows distinctive pathological, radiological, and clinical features. Different subtypes of extranodal lymphoma may show sufficiently specific radiological features to be of significant value in both establishing a diagnosis of lymphoma and ascertaining the exact subtype. Rapidly evolving lymphoma classifications and emergence of new entities have, however, hampered the accurate description of these features in the literature. In this review, we discuss the radiological appearances, using a variety of imaging methods, of the full spectrum of primary extranodal lymphomas, categorized according to the current World Health Organisation classification.
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Affiliation(s)
- S C Chua
- Department of Nuclear Medicine, PET, and Radiology, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.
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29
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A case of primary lymphoma of the bladder managed with multimodal therapy. ACTA ACUST UNITED AC 2008; 5:167-70. [PMID: 18212793 DOI: 10.1038/ncpuro1035] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 11/29/2007] [Indexed: 11/08/2022]
Abstract
BACKGROUND A 65-year-old female patient presented to a urology department with macroscopic hematuria, dysuria, urinary frequency and urgency. One year previously, she had visited a urologist because of a 1-month history of hematuria, dysuria, urinary frequency and urgency. She had subsequently undergone successful, simultaneous surgeries for resection of a basal cell carcinoma of the nasal skin and lymphoma of the bladder. INVESTIGATIONS Physical examination, measurement of serum urea, creatinine and electrolyte levels, peripheral blood film evaluation, ultrasonography, intravenous pyelography, abdominal, thoracic and pelvic CT, bone marrow aspiration and biopsy, cystoscopy and pathologic examination. DIAGNOSIS Primary lymphoma of the bladder. MANAGEMENT Transurethral resection, chemotherapy, radiotherapy and follow-up comprising cystoscopy, biopsy, CT imaging and immunocytologic analyses of urine samples.
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30
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Evans DA, Moore AT. The first case of vesico-vaginal fistula in a patient with primary lymphoma of the bladder - a case report. J Med Case Rep 2007; 1:105. [PMID: 17900354 PMCID: PMC2092432 DOI: 10.1186/1752-1947-1-105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 09/27/2007] [Indexed: 11/10/2022] Open
Abstract
Background Primary lymphoma of the bladder is a rare condition with less than 100 cases reported in the literature. Case presentation Here we present the case of a 64 year old woman with a 9 month history of haematuria, frequency, urinary incontinence and weight loss. Cystoscopy revealed a solid tumour throughout the whole bladder wall and a vesico-vaginal fistula. This was confirmed on CT scan which also showed no other organ involvement and bilateral hydronephrosis. Trans urethral biopsies taken at cystoscopy revealed Non-Hodgkin's Lymphoma. The patient had a nephrostomy inserted and is currently receiving a course of chemotherapy. Conclusion We believe this is the first documented case of primary bladder lymphoma causing a fistula and therefore we suggest that lymphoma should be included in the differential for any patient with a fistula involving the bladder.
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Affiliation(s)
- David A Evans
- Kings Mill Hospital, Mansfield Road, Sutton-In-Ashfield, Nottinghamshire, NG17 4JT, UK
| | - Andrew T Moore
- Kings Mill Hospital, Mansfield Road, Sutton-In-Ashfield, Nottinghamshire, NG17 4JT, UK
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31
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Pastuszka A, Slusarczyk K, Koszutski T, Kudela G, Kawalski H. Intravesical vaccination against Helicobacter pylori in patients with chronic cystitis may confer protection against MALT-type lymphoma of the bladder. Med Hypotheses 2007; 69:1160-1. [PMID: 17825999 DOI: 10.1016/j.mehy.2007.01.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Accepted: 01/31/2007] [Indexed: 11/28/2022]
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32
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Riccioni R, Carulli G, de Maria M, Pacini S, Cagno C, Selli C, Petrini M. Primary lymphoma of the bladder: case report. Am J Hematol 2006; 81:77-8. [PMID: 16369978 DOI: 10.1002/ajh.20466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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33
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Alvarez Alvarez C, Vieites Pérez-Quintela B, Pesqueira Santiago D, Santos Armentia E, San Miguel Fraile P, Antón Badiola I. [Primary non-Hodgkin large B-cell lymphoma of bladder. Report of a case]. Actas Urol Esp 2005; 29:902-4. [PMID: 16353778 DOI: 10.1016/s0210-4806(05)73363-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION primary genitourinary lymphomas are uncommon. Among them, bladder lymphomas are extremely unusual tumors, with clinico-radiological features similar to urothelial carcinomas of bladder. Histopathological, immunohistochemical and molecular studies are compulsory for the diagnosis. We report a case of this tumor. CLINICAL CASE An 80-year-old woman was admitted to our hospital with hematuria. Abdominal ultrasound and cystoscopy revealed an infiltrating bladder tumor involving the right lateral wall. After transuretral biopsy, a diagnosis of non-Hodgkin large B-cell lymphoma was made. Neither clinical symptoms nor radiological findings showed disseminated disease, indicating that the tumor was localized in the bladder. After chemotherapy, the patient is disease-free after 9 months follow-up. COMMENT if a bladder tumor with uncommon histopathological features is found, lymphoma should be excluded, because chemotherapy avoids cystectomy.
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34
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Pai SA, Naresh KN, Patil PU. Systemic anaplastic large cell lymphoma presenting as a bladder neoplasm. Leuk Lymphoma 2004; 45:841-3. [PMID: 15160969 DOI: 10.1080/10428190310001615927] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Non-Hodgkin's lymphoma is known to involve the bladder, either primarily or secondary. Anaplastic large cell lymphoma has not been documented at this site before. We report a case of a systemic anaplastic cell lymphoma in a 22-year-old man who presented with multisystemic symptoms and signs, including those suggestive of bladder disease. He was HIV-negative. Biopsy of the bladder showed a high grade lymphoma composed of large cells with nuclei containing prominent nucleoli. The tumor cells expressed CD30, CD45, EMA and ALK-1. A diagnosis of anaplastic large cell lymphoma, of null cell phenotype was made. The lymph node biopsy showed similar features on hematoxylin and eosin section. The patient was put on a regime of CHOP and is disease-free 33 months after diagnosis.
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Affiliation(s)
- Sanjay A Pai
- Department of Pathology, Manipal Hospital, Airport Road, Bangalore 560 017, India.
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35
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Froehner M, Haase M, Hakenberg OW, Wirth MP. Urinary immunocytology for primary bladder B cell lymphoma. Urology 2004; 63:381-3. [PMID: 14972506 DOI: 10.1016/j.urology.2003.10.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2003] [Revised: 10/17/2003] [Accepted: 10/17/2003] [Indexed: 11/20/2022]
Abstract
Urinary immunocytology is described as a diagnostic tool in a patient with a primary high-grade, large-cell, B cell lymphoma of the bladder. Lymphoma cells were distinguished from abundant leukocytes by immunocytologic staining for CD20. This technique might be useful in the differential diagnosis of patients with chronic bladder inflammation accompanied by pyuria.
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MESH Headings
- Aged
- Antigens, CD20/analysis
- Antigens, Neoplasm/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- B-Lymphocytes/chemistry
- Biomarkers
- Chlorambucil/administration & dosage
- Combined Modality Therapy
- Cystectomy
- Cystitis/diagnosis
- Diagnosis, Differential
- Fatal Outcome
- Female
- Humans
- Leukocytes/chemistry
- Lymph Node Excision
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/surgery
- Lymphoma, Large B-Cell, Diffuse/urine
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/surgery
- Lymphoma, Non-Hodgkin/urine
- Mitoxantrone/administration & dosage
- Neoplastic Stem Cells/chemistry
- Prednisolone/administration & dosage
- Pyuria/diagnosis
- Urinary Bladder Neoplasms/drug therapy
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/surgery
- Urinary Bladder Neoplasms/urine
- Urine/cytology
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Affiliation(s)
- Michael Froehner
- Department of Urology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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36
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Abstract
OBJECTIVES Non-urothelial bladder tumors frequently present a diagnostic and therapeutic challenge. We review the peer-reviewed literature to summarize the available evidence on the etiology, diagnosis and optimal management of malignant non-urothelial bladder tumors. METHODS A comprehensive MEDLINE database search was performed. In addition, the proceedings of recent national and international urological and cancer society meetings were reviewed. RESULTS Primary non-urothelial bladder tumors are rare in Europe and North America representing less than 5% of all bladder lesions combined. A large number of risk factors have been implicated in the etiology of non-schistosomiasis-related squamous cell carcinoma, yet their exact pathomechanism remains poorly defined. Squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma and carcinosarcoma/sarcomatoid tumors share an unfavorable prognosis despite aggressive surgical management that relates both to an aggressive biological behaviour as well as to an often times advanced stage at the time of diagnosis. Inflammatory pseudotumors are benign tumors of uncertain histogenesis that may mimic sarcomas. Paraganglioma, primary melanoma and lymphoma represent additional, exceedingly rare bladder tumors. CONCLUSIONS The systematic investigation of most non-urothelial bladder tumors is limited by the rarity of these lesions. A concerted effort of multiple institutions linked together in a national or international tumor registry will be necessary to advance our understanding of these tumors, evaluate treatment strategies and optimize patient outcome in the future.
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Affiliation(s)
- Philipp Dahm
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Coskun U, Günel N, Eroglu A, Biri H, Poyraz A, Gurocak S, Musa Bali MD. Primary high grade malignant lymphoma of bladder. Urol Oncol 2002; 7:181-3. [PMID: 12644213 DOI: 10.1016/s1078-1439(02)00186-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Primary malignant lymphoma of bladder is one of the rarest extranodal site for lymphomas. Less than 100 cases have been reported so far. A history of chronic cystitis has been shown to be a preceding feature in many cases (40%) of primary bladder lymphoma. Most of the cases reported in the literature have a low-grade lymphoma including the subtypes of mucosa-associated lymphoid tissue. The diffuse large cell lymphoma is the most frequent type among the subtypes of high-grade bladder lymphomas. In this report, a case with high-grade primary malignant lymphoma of bladder is reported and the clinical, pathological aspects of diseases are reviewed.
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Affiliation(s)
- Ugur Coskun
- Gazi University Medical School, Department of Medical Oncology, Ankara, Turkey.
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Kröber SM, Aepinus C, Ruck P, Müller-Hermelink HK, Horny HP, Kaiserling E. Extranodal marginal zone B cell lymphoma of MALT type involving the mucosa of both the urinary bladder and stomach. J Clin Pathol 2002; 55:554-7. [PMID: 12101213 PMCID: PMC1769687 DOI: 10.1136/jcp.55.7.554] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Primary lymphoma of the urinary bladder is a very rare tumour. A bladder tumour was found in a 57 year old man with obstructive dysuria. It was found by histological and immunohistohistochemical investigation to be an extranodal marginal zone B cell lymphoma. Lymphoepithelial lesions were absent, but were found in a clinically silent gastric lymphoma discovered four weeks later during staging investigations; this gastric lymphoma was negative for Helicobacter pylori by breath test and molecular biological analysis. Sequencing of the clonal immunoglobulin heavy chain gene in both tumours indicated the same precursor cell, of follicular or post follicular origin. In synopsis, the data suggested that this was a case of primary lymphoma of the bladder with involvement of the stomach. The application of a chromosome 3 specific alpha satellite probe revealed trisomy 3. A tumour with these characteristics arising as a lymphoma of the bladder with a metachronous involvement of the gastric mucosa has not been described previously.
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Affiliation(s)
- S M Kröber
- Institute of Pathology, University of Tübingen, Liebermeisterstrasse 8, Germany.
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van den Bosch J, Kropman RF, Blok P, Wijermans PW. Disappearance of a mucosa-associated lymphoid tissue (MALT) lymphoma of the urinary bladder after treatment for Helicobacter pylori. Eur J Haematol 2002; 68:187-8. [PMID: 12028368 DOI: 10.1034/j.1600-0609.2002.01649.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A59-yr old man presented with macroscopic hematuria. A non-Hodgkin's lymphoma of the MALT type of the urinary bladder, stage I A-E, was diagnosed. Radiotherapy was advised, but the patient refused this kind of treatment. Because of the known relationship of a gastric MALT lymphoma and Helicobacter pylori, the patient was treated with HP eradication therapy. Afterwards the lymphoma disappeared. The patient is 3 yr later in a persistent complete remission. This is the first known case of the disappearance of a MALT lymphoma of the urinary bladder after treatment with HP eradication therapy.
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Affiliation(s)
- J van den Bosch
- Department of Hematology, Leyenburg Hospital, The Hague, The Netherlands.
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