Treatment-refractory non-Hodgkin lymphoma of the prostate: A case report and review of the literature

Abstract

Non-Hodgkin lymphoma of the prostate is uncommon. Prostate specific antigen and transrectal ultrasound do not aid in diagnosis. Survival and treatment options are ultimately based on immune-histologic subtype and stage. Lower urinary tract symptoms attributed to lymphoma of the prostate can be refractory to systemic treatments as well as transurethral resection. This case provides the first description of the longitudinal clinical course of treatment-refractory localized Non-Hodgkin lymphoma of the prostate.

Keywords: BPH, benign prostatic hyperplasia; CLL; CLL, chronic lymphocytic leukemia; CT, computed tomography; LUTS, lower urinary tract symptoms; NHL, non-Hodgkin lymphoma; Non-hodgkin lymphoma; PSA, prostate specific antigen; Prostate; TURP; TURP, transurethral resection of prostate; UTI, urinary tract infection.

Fig. 1

CT showing prostatic enlargement with left retroperitoneal and inguinal lymphadenopathy.

Fig. 2

Prostate chips demonstrating benign prostatic glands (arrows) engulfed by a diffuse infiltrate of small lymphoid cells. Hematoxylin and Eosin stains, 100X. The lymphoid cells are positive (not demonstrated) for CD20, PAX5, CD5, CD23 and negative for cyclin D1, with low MIB-1 proliferative index, consistent with B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia.

Fig. 3

Improvement of lymphadenopathy and interval decreased prostate size after systemic treatment and TURP.