Prostatic Lymphoma Masquerading as Urinary Retention and Hematuria With Review of Literature

Abstract

Lymphomas of prostate are very rare tumors. They are not commonly considered in the clinical and histological differential diagnosis of prostatic enlargement. We report a case of a 49-year-old man who presented to emergency department with several weeks of difficulty in urination, for which he was being treated for benign prostate hyperplasia with no improvement. Computerized tomography scan showed lobulated mass originating from the superior aspect of the prostate with right inguinal lymph node involvement and no distant organ metastatic disease. Prostatic biopsy revealed diffuse large B-cell lymphoma. The patient achieved complete remission after six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimen. Lymphomas of the prostate should be considered in differential diagnosis of the patient presenting with obstructive lower urinary tract symptoms especially in patients with normal prostatic-specific antigen level and previous history of lymphoma in other sites.

Keywords: Lymphoma; Non-Hodgkin diffuse-large B-cell lymphoma; Prostate; Prostate hyperplasia.

Figure 1

A 7 × 4 cm lobulated mass below the base of the bladder, arising from the superior aspect of the prostate and invading the seminal vesicles.

Figure 2

Prostate biopsy: low power view of the prostate core showing a diffuse proliferation of atypical pleomorphic cells.

Figure 3

Prostate biopsy: high power (× 40) view showing cellular pleomorphism and nuclear karyorrhexis.