Yokoyama Minato, Kobayashi Tsuyoshi, Kubo Yuichi, Kageyama Yukio, Kihara Kazunori
The Department of Urology, Tokyo Medical and Dental University.
Hinyokika Kiyo. 2006 Apr;52(4):285-7.
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.
一名56岁男性因复发性弥漫性大B细胞恶性淋巴瘤（临床分期为IIIb期）接受挽救性化疗入院，此前已接受6个周期的环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）治疗。计算机断层扫描显示在接受异环磷酰胺、依托泊苷和米托蒽醌（MINE）一个周期治疗后膀胱出现多个肿瘤，但在第二个周期后膀胱镜检查发现一个直径约1厘米的非乳头状单一肿瘤。在接受3个周期的MINE治疗后，进行了经尿道膀胱肿瘤切除术。手术时，突出的病变消失，仅留下一个瘢痕。瘢痕活检显示恶性淋巴瘤浸润至黏膜下层。尽管在尸检病例中恶性淋巴瘤累及膀胱的发生率为3%-20%，但临床上诊断为继发性膀胱恶性淋巴瘤非常罕见。继发性膀胱淋巴瘤的预后比原发性膀胱淋巴瘤差得多，因为在诊断时疾病已广泛播散。
