Primary malignant lymphoma of the urinary bladder: report of a case

A case of primary malignant lymphoma of the bladder is reported. A 73-year-old woman was admitted to our clinic with the chief complaint of asymptomatic gross hematuria on January 11, 1982. Preoperative examinations with cystoscopy, DIP, cystogram, CT scan, ultrasonography and transurethral biopsy suggested a non-epithelial tumor of the bladder. Partial cystectomy was performed on March 31, 1982. Histological diagnosis was diffuse lymphoma, medium-sized cell type by the classification of LSG (The lymphoma-leukemia study group of Japan). One month later, she was treated with VEPA therapy, which consisted of vincristine, cyclophosphamide (Endoxan), prednisolone and adriamycin. Postoperative course was uneventful and she has been doing well without any clinical evidence of recurrence during the period of 11 months following the operation.     

Primary malignant lymphoma of urinary bladder

A case of primary malignant lymphoma of the urinary bladder is described. The classic presentation of gross hematuria and dysuria with a benign clinical course is illustrated. From a review of the literature and our experience, we conclude that localized primary lymphoma of the bladder, especially those with favorable histologic findings, often does not require medical or surgical intervention. Persistent irritative bladder symptoms can be palliated adequately with external beam radiotherapy, while surgical intervention is rarely indicated.     

Primary malignant lymphoma of the ureter: a case report

A 58-year-old man who had right hydronephrosis pointed out by medical checkup visited our hospital. Computed tomography and retrograde pyelography revealed a soft tissue mass in the middle portion of the right ureter. Urine cytology specimen from the right ureter suggested transitional cell carcinoma. Under the diagnosis of right ureteral cancer, we performed right total nephro-ureterectomy, partial cystectomy. The histopathological examination showed non-Hodgkin lymphoma (large B-cell type) of the ureter. Our diagnosis was Clinical Stage IE of the Ann Arbor Classification. The patient received only the first course of systemic chemotherapy (THP-cop), because he suffered severe thrombocytopenia in the course of the chemotherapy. No recurrence was found for 15 months after operation, and at present he is disease-free.     

Metastatic malignant melanoma of the urinary bladder: a case report

A 77-year-old male was admitted to our department with the chief complaint of positive occult blood in urine on July 30, 1984. Endoscopically, we found a dark red tumor on the left posterior wall of the urinary bladder, which seemed to have coagula covering it. On August 31, transurethral resection of the bladder tumor (TUR-Bt) was performed, and the pathological interpretation was malignant melanoma. Dermatologically and ophthalmologically, we could not found the primary foci. A month later, cystoscopy demonstrated multiple blue black spots consistent with diffuse melanoma of the bladder. On May 7, 1985, he was admitted to our clinic with right hypochondralgia. On physical examination, the liver was palpable with an irregular surface, and the echogram showed multiple metastasis in the liver. TUR-Bt was carried out again, on May 17, 1985. Ultrastructually resected specimens demonstrated a lot of mature melanosomes in the tumor cells. The course of the patient progressively worsened, and he died on May 30, 1985. At autopsy, we found metastases in the central nervous system, bone, genitourinary tract, gastrointestinal tract and other organs. The left eye ball, which had been diagnosed as ophthalmomalacia by glaucoma six years earlier, was filled by a melanoma mass, and it seemed to be the primary foci.     

Primary localized amyloidosis of the urinary bladder: a case report

A case of primary localized amyloidosis of the bladder during a twelve-year period is described. The initial symptom was miction pain when she was 43 years old. Cystoscopic examination revealed yellowish elevated lesion with hemorrhage at the right side of the bladder neck. Transurethral resection was performed, but two years later recurrence was found at the trigonum as well as the original site. The two lesions were apart. She remained asymptomatic for the following ten years until she returned to us with bladder symptoms. Cystoscopy showed the lesion was more diffuse and the posterior wall was involved in continuity with the trigonum. Complete transurethral resection was not possible because of generalized bladder involvement. Our case illustrates the clinically benign but slowly progressive nature of amyloidosis of the bladder. Multifocal recurrence is also to be noted. Our current treatment policy is conservative treatment with careful follow-up. She is asymptomatic three months postoperatively.     

A collision cancer between urothelial carcinoma and malignant lymphoma of the urinary bladder: a case report

A man in his 70's visited the Department of Internal Medicine due to lumbago that had first appeared two months previously. Abdominal computed tomography showed a low-density area in the liver and swelling of lymph nodes surrounding the abdominal aorta. Four months later, he was hospitalized on an emergency basis in a urology ward in order to control bladder tamponade. Cystoscopy revealed massive blood clots and a papillary tumor at the left wall of the urinary bladder. He underwent transurethral resection of a bladder tumor, and the pathological diagnosis was a collision tumor between urothelial carcinoma (G2, pTa) and malignant lymphoma (B cell type). He underwent a liver biopsy soon thereafter, and the pathological diagnosis was malignant lymphoma (as for the one found in the urinary bladder). Bladder tamponade was repeated, which was relieved after one course of chemotherapy for malignant lymphoma. He underwent six courses of chemotherapy (THP-CO), and he was well without recurrence of either malignant lymphoma or urothelial carcinoma with 3 years' follow-up. To our knowledge, this is the 14th reported case of a collision tumor in the urinary tract.     

Primary penile malignant lymphoma: report of a rare case

A 73-year-old male presented with a 3-month history of two penile masses: one on the shaft and one on the glans penis. Both lesions were poorly defined, fixated and without tenderness. The sizes were 1.0 × 1.0 × 1.0 cm and 1.2 × 1.5 × 1.5 cm, respectively. The patient underwent lumpectomy of the glans penis; we confirmed malignant lymphoma of the glans penis (B-cell derived; diffused large B-cell) by postoperative pathological examinations. CHOP (cyclophosphamide-hydroxydaunorubicin-oncovin-prednisone) chemotherapy was administered. The patient was tumour-free at the 33-month follow-up.Primary penile malignant lymphoma is very rare, there are only 26 reported cases worldwide.A 73-year-old male presented with a 3-month history of penile mass; he was otherwise healthy. Physical examinations indicated the following: normal vital signs, with no enlarged superficial lymph nodes; no abnormalities in cardiopulmonary examination; flat abdomen; liver and spleen were impalpable, with no palpable mass; kidney was impalpable, with no tenderness. Digital rectal examination revealed a hyperplastic prostate, with no nodule. Two masses were discovered on the shaft of penis and glans penis; the masses were firm, poorly defined, fixated and no tenderness. Their respective sizes were: 1.0 × 1.0 × 1.0 cm and 1.2 × 1.5 × 1.5 cm. Routine blood/urine tests, liver and kidney function tests were normal. His prostate-specific antigen was 3.05 ng/mL. Upon ultrasound and computed tomography (CT) scanning, his prostatic hyperplasia measured 3.0 × 4.0 × 4.5 cm and was 28.08 mL; there were no abnormalities with the liver, gallbladder, pancreas, spleen, kidneys and ureter, and no enlargement of the retroperitoneal lymph nodes. A plain chest radiograph showed no abnormalities.The patient underwent lumpectomy of the glans penis. At surgery, the mass on the shaft was unable to be resected, and thus only a biopsy tissue was taken. The mass on the glans penis was completely resected with some surrounding normal tissue, and primary suturing of the glans was performed. Pathological examinations indicated malignant lymphoma of the glans penis (B-cell derived; diffused large B-cell), and the mass margins on the glans were tumour-free; immunohistochemistry tests (Fig. 1, Fig. 2) indicated: CD3(−), CD792(+), LCA(+), L26(+), BCL6(−), BCL10(−), UCHL1(−), KP−1 cell(+). Postoperative bone marrow biopsy showed trilineage hyperplasia; lymphocyte showed no significant abnormalities in percentage and morphology. Chemotherapy was administered after the operation: CHOP (500 mg/m² cyclophosphamide and 30–50 mg/m² adriamycin and l–2 mg oncovin intravenously infused on day 1; and 40 mg prednisone taken orally on days 1–5, with an interval of 3 weeks between two courses of treatment). Physical examination, routine blood/urine tests, liver and kidney function tests, serum electrolytes, serum tumour makers, plain chest radiograph, abdominal and pelvic CT were examined to exclude recurrence and metastasis at each follow-up (postoperative month 3, 6, 9 and years 1 and 2. The follow-up showed regression of the mass on the shaft of penis and no signs of recurrence.Open in a separate windowFig. 1Hematoxylin and eosin staining of primary penile lymphoma, ×400.Open in a separate windowFig. 2Immunohistochemistry: leukocyte common antigen-positive tumour cells presented brown, ×400.     

A case of primary malignant lymphoma of the urinary bladder

This paper presents an autopsy case of primary malignant lymphoma of the urinary bladder. The patient, a 63-year-old man, consulted us because of macroscopic hematuria. Cystoscopy revealed a bladder tumor, which was diagnosed as an anaplastic cell carcinoma by transurethral punch biopsy. The tumor progressively increased in size, despite treatment with preoperative antineoplastic chemotherapy consisting of CDDP. Only ureterocutaneostomy and biopsy were performed at the operation although total cystectomy and ileal conduit had been planned, because the tumor had invaded into the perivesicular tissue. Biopsy revealed B cell lymphoma, which was characterized by specific staining with IgG by the PAP method. Although antineoplastic chemotherapy was performed again after operation, the patient gradually weakened and died 5 months after admission. At autopsy, a hen-egg sized, non-papillary tumor which invading into the perivesicular tissue was found at the anterior wall of the urinary bladder. There were many metastatic nodules in the thraco-lumbar vertebral columns, para-aortic lymphnodes and mesenteric lymphnodes. Lungs and liver were free from metastatic tumors.     

A case of secondary malignant lymphoma of the urinary bladder

A case of secondary malignant lymphoma of the urinary bladder is presented. Clinical diagnosis was metastatic small cell carcinoma in urinary bladder. Pathological diagnosis after autopsy, however, revealed vesical involvement of malignant lymphoma. The primary focus was considered to be the lung, the biopsy specimen of which was initially diagnosed as small cell carcinoma, because clinical manifestation first occurred in the lung and the metastasis to subcutaneous tissue, bladder and other abdominal organs was found subsequently. In a study of secondary involvement of genitourinary organs as seen in the present case, we reviewed 303 patients who had died of malignant lymphoma at our institute between 1960 and 1985.     

A case of secondary malignant lymphoma of the urinary bladder

A 56-year-old man was admitted to our hospital for salvage chemotherapy of recurrent diffuse large B cell malignant lymphoma at clinical stage IIIb and which had been treated with 6 cycles of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP). Computed tomography showed multiple tumors in the bladder after a cycle of ifosfamide, etoposide and mitoxantrone (MINE), but cystoscopy after the second cycle revealed a single non-papillary tumor about 1cm in diameter. After 3 cycles of MINE therapy, transurethral resection of bladder tumor was performed. At the time of the operation, the protruded lesion disappeared and there remained only a scar. Biopsy of the scar revealed malignant lymphoma infiltrated into the submucosal layer. Although the rate of the bladder involvement of malignant lymphoma reaches 3-20% in autopsy cases, it is very rare for a secondary malignant lymphoma of the urinary bladder to be diagnosed clinically. The prognosis of the secondary bladder lymphoma is much poorer than that of the primary one, because of the widespread dissemination of the disease at the time of diagnosis.     

Primary AA type amyloidosis of the urinary bladder: a case report

Primary amyloidosis of the urinary bladder is a rare disease entity. A total of 61 cases have been reported in the Japanese literature, and most of them were AL type amyloidosis. We report here a case of primary AA type amyloidosis. A 52-year-old man presented with a chief complaint of asymptomatic gross hematuria. Cystoscopy revealed yellowish elevated lesions, transurethral mucosal biopsies were performed, and the histopathological diagnosis indicated a primary AA type amyloidosis of the urinary bladder. Systemic amyloidosis was clinically eliminated. The yellowish lesions in the bladder through cystoscopy disappeared spontaneously one year later without any specific treatment, but periodical work-up may be necessary to rule out recurrence of the disease or bladder tumor.     

Primary signet-ring cell carcinoma of the urinary bladder: a case report

We report a case of signet-ring cell carcinoma of the urinary bladder. A 48-year-old female was hospitalized because of general fatigue, pollakiuria and residual sensation. Renal ultrasonography disclosed bilateral hydronephrosis. The serum level of cretinine was 3.1 mg/dl, and we diagnosed the patient with post-renal failure. Cystoscopic examinations revealed non-papillary sessile tumors in the trigone. Histopathological findings of the biopsy specimen demonstrated signet-ring cell carcinoma. There was no evidence indicating bladder metastasis from the cancer in other organs. The patient died of cachexia 5 months after the diagnosis. She was autopsied, and the diagnosis of signet-ring cell carcinoma of the urinary bladder with metastases in various organs was confirmed. This disease is extremely rare and has a poor prognosis. We review the previous cases reported in the literature.     

Primary malignant lymphoma of the bladder. A case report and review of the literature

Primary malignant lymphoma of the bladder is unusual. We report a case of primary malignant lymphoma arising in the urinary bladder. A 54-year-old woman was admitted to our hospital with the chief complaint of dysuria, on May 26, 1995. Examination of IVP, ultrasonography, cystoscopy suggested a non-papillary bladder tumour. Diagnosis was established by histological examination.     

Primary intracranial T cell type malignant lymphoma: a case report

Primary intracranial T cell type malignant lymphoma is extremely rare. Only 8 cases are reported in the literature so far. In this paper, a case with this type of malignant lymphoma is reported. A 41-year-old man was admitted because of abnormal behavior. Enhanced CT scan demonstrated high density mass and perifocal low-density area in the right frontal lobe, the right basal ganglia and the periventricular region. Specimen biopsied from right frontal lobe was submitted for histological examination. An immunohistochemical technique using monoclonal surface markers confirmed reactivity for LCA, MT-1, OKT-4 and OKT-8, while there was no reactivity for MB-1 and OKB-2. Pathological diagnosis was diffuse medium T cell type malignant lymphoma. Postoperatively, after 60 Gy irradiation, the tumor disappeared. There is no difference on CT findings between B cell type and T cell type malignant lymphoma.     

Primary malignant lymphoma of the rib; report of a case

We experienced a rare case of primary malignant lymphoma of the rib. The case was a 67-year-old female. An abnormal shadow of the chest X-ray was pointed out. Preoperative diagnosis was extrapulmonary lesion on the chest computed tomography (CT) and magnetic resonance imaging (MRI). The tumor accompanied with chest wall resection was done. The tumor cell was appeared in the bone marrow diffusely. The tumor invaded the canal of bone cortex and expanded the neighbor tissue. Histologically tumor was diagnosis of the malignant lymphoma, diffuse large B-cell type, stained by negative in L 26, positive in CD 43, positive in CD 79 a, negative in UCHL-1, and negative in CD 3. EBV-encoded small RNAs (EBERs) and EBV-EBNA 2 was negative. This tumor was not able to proved to Epstein-Bar virus.     

Primary malignant lymphoma of the bladder

We treated 11 patients with primary malignant lymphoma of the bladder. The typical patient is a woman more than 50 years old who presents with urgency and frequency of micturition, and occasionally gross hematuria. Hydronephrosis is present in half of the patients and cystoscopy usually reveals a solid tumor. Partial cystectomy, when feasible, with or without radiotherapy and chemotherapy is the usual treatment modality. When localized to the bladder, malignant lymphoma has an over-all favorable prognosis.