Malignant lymphoma involving the prostate: Report of 62 cases

Department of Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cancer (Impact Factor: 4.89). 08/1998; 83(4):732-8.
Source: PubMed


Malignant lymphoma involving the prostate is rare, and to the authors' knowledge the factors determining patient outcome have not been studied in a large series.
The authors evaluated the clinical and pathologic findings in 60 cases of non-Hodgkin's lymphoma and 2 cases of Hodgkin's lymphoma involving the prostate. A variety of clinical and histologic findings were considered as factors predictive of patient outcome.
Lymphoma tended to occur in elderly men, with a mean age at diagnosis of 62 years (range, 5-89 years), although 6 patients were age < 40 years (ages 5, 19, 30, 32, 38, and 38 years, respectively). Clinical signs and symptoms were due to lower urinary tract obstruction. Twenty-two patients (35%) presented with primary extranodal lymphoma of the prostate with a variety of histologic subtypes, including small lymphocytic (4 patients); follicular center cell, diffuse, small cell (2 patients); follicular center cell, Grade 1 (according to the revised European-American classification (small cleaved) (1 patient); Grade 2 (mixed) (1 patient); diffuse large B-cell (12 patients); and high grade B-cell lymphoma, Burkitt-like (2 patients). At the time of presentation, none of these patients had hepatosplenomegaly, inguinal lymphadenopathy, or an abnormal complete blood count. Thirty other patients (48%) with previously documented lymphoma at other sites developed prostatic involvement; these secondary prostatic lymphomas displayed a variety of subtypes, including small lymphocytic (8 patients, all with concomitant leukemia); follicular center cell lymphoma, diffuse, small cell (2 patients); follicular center, Grade 1 (small cell) (1 patient); follicular center, Grade 2 (1 patient); diffuse large B-cell (11 patients); peripheral T-cell lymphoma (2 patients); high grade B-cell lymphoma, Burkitt-like (1 patient); Burkitt's lymphoma (1 patient); Hodgkin's lymphoma (nodular sclerosing [1 patient] and mixed cellularity [1 patient]); and unknown (1 patient). Ten cases were not classifiable as primary or secondary lymphomas. Twenty-five patients died of malignant lymphoma, 14 died of unknown or other causes, 18 patients were alive 12-20 months after diagnosis (8 primary and 10 secondary tumors; 3 had persistent lymphoma; all treated since 1981), and 5 were lost to follow-up. Lymphoma specific survival was 64% at 1 year (95% confidence interval [CI], 51-80%), 50% at 2 years (95% CI, 36-68%), 33% at 5 years, 33% at 10 years, and 16% at 15 years. There was no difference in median survival after diagnosis of prostatic involvement between primary and secondary lymphoma (23 months vs. 28 months, respectively) or among histologic types.
Although malignant lymphoma involving the prostate is rare, it should be considered in the differential diagnosis of lower urinary tract obstruction, particularly in patients with a previous history of lymphoma.

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    • "Though the most common type of non-Hodgkin's lymphoma in children, prostate involvement of Burkitt's lymphoma is uncommon and accounts for <0.1% of genitourinary involvement [4]. In a multi-institutional study of 62 cases of malignant lymphoma involving the prostate, only one case was found to be Burkitt's lymphoma; this happened to be in the single child [5]. In this case series, there was a 5-year-old boy with secondary involvement of the prostate by Burkitt's lymphoma, who died 1 week after diagnosis. "
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    ABSTRACT: Burkitt's lymphoma is the most frequent subtype of non-Hodgkin's lymphoma in childhood. Radiographic findings are protean and can often overlap with other neoplastic and nonneoplastic processes. We present an unusual case of Burkitt's lymphoma in a 12-year-old boy presenting with a one-week history of urinary retention, dysuria, and "tailbone pain," as well as a 4-week history of jaw pain, initially treated as a dental abscess. On dental radiography, the patient was found to have resorption of alveolar bone adjacent to the lower first molars bilaterally, in keeping with "floating teeth," classically associated with Langerhans cell histiocytosis. Additionally, a large, eccentric, prostatic mass was noted, prompting the inclusion of rhabdomyosarcoma on the differential diagnosis, with subsequent definitive diagnosis of Burkitt's lymphoma on tissue and bone marrow biopsy. This case highlights the imaging overlap of these childhood neoplasms with an unusual lymphomatous prostate mass. It is important that the radiologists and pediatricians be aware of this potential overlap and the unusual presentation of Burkitt's lymphoma.
    Full-text · Article · May 2014
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    • "The criteria used to classify the primary lymphoma of the prostate include that the main symptoms are urinary, the disease occurs predominantly in the prostate with or without extension to adjacent tissues, and there is no involvement of the lymph nodes, liver, spleen, or blood for up to one month after the diagnosis [4]. Our case fulfilled these criteria, therefore and the lymphoma was classified as a primary lymphoma. "
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    ABSTRACT: We herein report a case of primary lymphoma of the prostate, which arose in an 85-year-old male with dysuria. CT and MRI examinations demonstrated a large mass in the prostate. A transrectal ultrasound-guided biopsy of the prostate was performed. The histological examination showed diffuse large B-cell lymphoma. The large lesion in the prostate showed spontaneous regression. Spontaneous regression of primary lymphoma of the prostate has not been reported previously. The spontaneous regression of primary lymphoma of the prostate observed in this patient suggests that observation may represent a viable treatment option following a biopsy that has provided a histopathological diagnosis.
    Full-text · Article · Sep 2013
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    • "Lymphomas of prostate, either primary or secondary, are very rare. The types are mainly consisted of B-cell lymphomas [6], including diffuse large B-cell non-Hodgkin’s lymphoma (DLBL) [7], mucosa-associated lymphoid tissue (MALT) lymphoma [8], and mantle cell lymphomas [9]. Only three cases of T-cell lymphomas involving the prostate have been reported, but none of them was primary [10,11]. "
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    ABSTRACT: Extranodal NK/T cell lymphoma(NKTCL), nasal type, occurring primarily in the prostate gland, is extremely rare. We present a case of primarily prostatic NKTCL in a 59-year-old man suffering from dysuria. Histological examinations revealed that diffused, large-sized, pleomorphic lymphocytes were arranged in an angiocentric distribution with large areas of geographic necroses. Additionally, the prostatic glands were diffusely infiltrated by heteromorphous lymphocytes forming lymphoepithelial lesions. The tumor cells were strongly expressed CD3ϵ, CD56, TIA-1, granzyme B and EBV-encoded RNAs. And interestingly, the lymphoid cells were also strongly immunoreactive with CD30. A rearrangement study showed T-cell receptor γ-chain gene rearrangement with monoclonal appearance. Though postoperative combination of chemotherapy was given, the patient died four months later. Our observation and other literatures indicate that extremely rare NKTCLs unusually express CD30. TCR gene rearrangement existed in some NKTCL, suggesting that a subset of NKTCL may be a mixed NK/T-cell differentiation. Virtual slides The virtual slide(s) for this article can be found here:
    Full-text · Article · Jun 2013 · Diagnostic Pathology
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