Ochoa Undargarain Otto, Hermida Pérez José A, Ochoa Montes de Oca Johannes, Félix León Juan M
Hospital Provincial Manuel Ascunce Domenech, Camagüey, Cuba.
Arch Esp Urol. 2006 Jun;59(5):538-41. doi: 10.4321/s0004-06142006000500015.
To report a case of prostate lymphoma and a brief review of the literature.
METHODS/RESULTS: A 70 year-old mele patient was referred to the Urology departament with a clinical picture of prostatism, with acute urinary retention (AUR). Surgery with retropubic prostatectomy was performed, and pathology revealed a primary prostate lymphoma. The patient was referred to the departament of Oncology where he received polychemotherapy and radiotherapy. The patient is currently followed by regular visits to Urology outpatients service. The case study is followed by a brief bibliographic review, where we analyse clinical menifestations of this entity, complementary studies useful for diagnosis (laboratory test, trasrectal prostate biopsy, transuretral resection, ultrasound and computerised axial tomography), treatment options (surgery, polychemotherapy, radiotherapy) as well as survival in these patients.
Of the cases reviewed, mean age at diagnosis was 57 years. Clinical debut was with prostate symptoms, with or without AUR and sometimes manifestations of renal failure due to obstructive uropathy, as well as general symptoms (astenia, anorexia, weight loss). PSA values remain unaltered in prostate lymphoma patients. Histologic diagnosis may be made by transrectal prostate biopsy, although transurethral resection (TUR) may be necessary for confirmation. Ultrasound and CT scan are of great utility for diagnosis of both local and distant tumors. From a therapeutic point of view, surgery for the obstruction of the lower urinary tract (TURP or retropubic prostatectomy) may be necessary, as well as the cyclophosphamide based polychemotherapy with corticosteroids and other cytostatic agents, and radiotherapy; intratecal chemotherapy has also been used adjuvant bone marrow transplantation.
报告一例前列腺淋巴瘤病例并对文献进行简要综述。
方法/结果:一名70岁男性患者因前列腺增生伴急性尿潴留(AUR)被转诊至泌尿外科。实施了耻骨后前列腺切除术,病理检查显示为原发性前列腺淋巴瘤。该患者被转诊至肿瘤科,接受了多药化疗和放疗。目前患者定期到泌尿外科门诊随访。病例研究之后是简要的文献综述,我们分析了该疾病的临床表现、有助于诊断的辅助检查(实验室检查、经直肠前列腺活检、经尿道切除术、超声和计算机断层扫描)、治疗选择(手术、多药化疗、放疗)以及这些患者的生存率。
在所回顾的病例中,诊断时的平均年龄为57岁。临床首发症状为前列腺症状,伴或不伴AUR,有时还有梗阻性肾病导致的肾衰竭表现以及全身症状(乏力、厌食、体重减轻)。前列腺淋巴瘤患者的前列腺特异性抗原(PSA)值保持不变。组织学诊断可通过经直肠前列腺活检做出,不过经尿道切除术(TUR)可能对确诊有必要。超声和CT扫描对诊断局部及远处肿瘤非常有用。从治疗角度来看,可能需要对下尿路梗阻进行手术(经尿道前列腺电切术或耻骨后前列腺切除术),以及基于环磷酰胺的多药化疗联合皮质类固醇和其他细胞毒性药物,还有放疗;鞘内化疗也已用于辅助骨髓移植。