Primary Extranodal Diffuse Large B-Cell Lymphoma of the Prostate: A Case Report

Abstract

We report a case of primary diffuse large B-cell lymphoma of the prostate in a 54-year-old Caucasian male who presented with urinary retention and benign prostatic hyperplasia. We discuss the rare presentation of this disease and its clinicopathologic features and review the literature for up-to-date information on the diagnosis and clinical management. Despite the low incidence of lymphoma involving the prostate gland, it should always be considered as part of the differential diagnosis in cases of prostate gland enlargement with urinary tract obstructive symptoms resistant to medical therapy. Treatment modalities for this rare disease are also discussed.

Keywords: BCL-6; CD20; Diffuse large B-cell lymphoma; Primary prostatic lymphoma; R-CHOP; Transurethral prostatic resection.

Fig. 1.

Computed tomography scan of the abdomen/pelvis showing cecal mass (a) and enlarged prostate (b). The scan shows a prostatic space-occupying lesion with unclear rectal boundaries and an absence of the bladder seminal vesicle angle.

Fig. 2.

Positron emission tomography scan showing increased uptake in the prostate prior to therapy (a) and decreased metabolic activity following treatment (b) and 12 months after therapy (c).

Fig. 3.

A The prostate transurethral resection specimen was remarkable for a diffuse infiltrate of large atypical lymphoid cells and background small mature lymphocytes (a). The large atypical cells consisted of a mixture of immunoblast-like and centroblast-like cells that replaced the normal prostate parenchyma (b). (Hematoxylin and eosin at 200× magnification.) B Immunohistochemical staining of the large atypical lymphoid cells showed diffuse positivity with CD20 (a) and BCL-6 (b). Overall, the immunohistochemical staining patterns were consistent with a diagnosis of diffuse large B-cell lymphoma. (Both images at 200× magnification.)