Terzic Tatjana, Radojevic Sanja, Cemerikic-Martinovic Vesna, Stevanovic Radmila, Citlucanin Sanja, Mitrovic Dragan, Stojimirovic Biljana, Markovic-Lipkovski Jasmina
Institute of Pathology, School of Medicine, University of Belgrade, dr Subotica 1, 11000 Belgrade, Serbia.
Med Oncol. 2008;25(2):248-50. doi: 10.1007/s12032-007-9025-z. Epub 2007 Nov 27.
Primary bladder non-Hodgkin lymphoma (PBNHL) is very rare, especially as extranodal B-small lymphocytic lymphoma (B-SLL). Also, late isolated renal manifestation of PBNHL is extremely unusual. We report a very rare type of extranodal B-SLL of bladder wall with extremely unusual late isolated renal involvement, clinically manifested by nephrotic syndrome and incipient renal failure.
A 56-year-old woman was presented with a solitary tumor of bladder wall, with history of dysuria and night sweating. A transvaginal needle biopsy of the tumor was performed, and diagnosis of primary extranodal B-SLL was made in the absence of bone marrow, lymph node, or blood involvement. She was treated with chemotherapy until the achievement of complete remission. Nine years later, she developed nephrotic syndrome. The renal biopsy revealed parenchymal lymphoma's involvement associated with glomerular lesion. Immunohistochemical analysis confirmed the same imunophenotype of lymphoma cells like in bladder wall nine years ago. Restaging procedure showed no evidence of disease elsewhere.
To our knowledge, it is the first case of association of very rare primary bladder B-SLL with late isolated renal involvement.
原发性膀胱非霍奇金淋巴瘤（PBNHL）非常罕见，尤其是作为结外B小淋巴细胞淋巴瘤（B-SLL）时。此外，PBNHL晚期孤立性肾脏表现极为罕见。我们报告了一种非常罕见的膀胱壁结外B-SLL类型，伴有极不寻常的晚期孤立性肾脏受累，临床表现为肾病综合征和早期肾衰竭。
一名56岁女性，有膀胱壁孤立性肿瘤，伴有尿痛和盗汗病史。对肿瘤进行了经阴道穿刺活检，在无骨髓、淋巴结或血液受累的情况下诊断为原发性结外B-SLL。她接受了化疗直至完全缓解。9年后，她出现了肾病综合征。肾脏活检显示实质淋巴瘤累及并伴有肾小球病变。免疫组化分析证实淋巴瘤细胞的免疫表型与9年前膀胱壁的相同。重新分期检查未发现其他部位有疾病证据。
据我们所知，这是首例非常罕见的原发性膀胱B-SLL伴晚期孤立性肾脏受累的病例。
