Incidental chronic lymphocytic leukemia diagnosed following radical prostatectomy for prostate cancer: A case report

Abstract

Background: chronic lymphocytic leukemia (CLL) patients have a high risk of occurrence of secondary cancers. This risk is three times higher for all cancers and eight times higher for skin cancer. The coexistence of CLL and adenocarcinoma of the prostate is rare.

Case presentation: We report a case of a66-year-old man who underwent radical prostatectomy for prostate carcinoma. The final histopathological diagnosis of Gleason 7 adenocarcinoma of the prostate with incidental Rai stage I chronic lymphocytic leukemia (CLL) was made. No further investigations or treatment was offered due to the age and low disease stage. At the last follow-up of 12 months, the patient is alive, without disease progression for both lymphoma and prostate, with a PSA value of 0.03 ng/ml.

Conclusion: Early detection of lymphoma after radical prostatectomy will allow optimal management. The analysis of this link requires, therefore, additional investigations.

Keywords: Chronic lymphocytic leukemia; Prostate carcinoma; Radical prostatectomy.

Fig. 1

Multi parametric abdominal magnetic resonance imaging (MP -MRI) showed the presence of a posterior prostate lesion measuring 16 mm, located in the left peripheral zone Magnetic hypointense on T2W (A) and markedly hyperintense on DWI (B).

Fig. 2

Microscopic examination of the prostate tissue showing crowded glands of adenocarcinoma with dense eosinophilic crystalloids [Gleason score 7 (4 + 3)] (A). The pelvic lymph node examination revealed small, round tumor cells with low grade of differentiation (H & E) (B) and positive staining for CD20 (C), CD5 (D) and CD23 (E).