Hori Yasuhide, Nishii Masahiiko, Masui Satoru, Yoshio Yuko, Hasegawa Yoshihiro, Kanda Hideki, Yamada Yasushi, Arima Kiminobu, Sugimura Yoshiki
The Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Japan.
Hinyokika Kiyo. 2013 Jun;59(6):377-80.
Here, we report a case of malignant lymphoma (ML) of the prostate. A 77-year-old man was referred to our hospital with the chief complaint of left lumbago. Computed tomography imaging showed a large mass below the bladder, as well as left hydronephrosis resulting from infiltration of the mass. Magnetic resonance imaging (MRI) revealed enlargement and high-intensity of the whole prostate with diffusionweighted image. An enlarged, stony, hard prostate was palpable on digital rectal examination, but the prostate-specific antigen (PSA) level was 4.65 ng/ml. Since the patient developed urinary retention and macrohematuria, transurethral hemostasis and biopsy were performed. Histological findings and immunohistochemical studies revealed diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). MRI is thought to play a critical role in localization diagnosis of Non-Hodgkin's lymphoma (NHL) since NHL demonstrates characteristic signs. Although the frequency of primary ML of the prostate is low, by paying careful attention to the characteristic signs on MRI and examination findings, we should consider a differential diagnosis of ML of the prostate, which is not a typical manifestation of prostatic cancer.
在此，我们报告一例前列腺恶性淋巴瘤（ML）病例。一名77岁男性因左侧腰痛为主诉被转诊至我院。计算机断层扫描成像显示膀胱下方有一个大肿块，以及因肿块浸润导致的左侧肾积水。磁共振成像（MRI）显示整个前列腺增大且在扩散加权图像上呈高强度信号。直肠指检可触及肿大、坚硬如石的前列腺，但前列腺特异性抗原（PSA）水平为4.65 ng/ml。由于患者出现尿潴留和肉眼血尿，遂进行了经尿道止血及活检。组织学检查结果和免疫组化研究显示为弥漫性大B细胞非霍奇金淋巴瘤（DLBCL）。由于非霍奇金淋巴瘤（NHL）表现出特征性征象，MRI被认为在NHL的定位诊断中起关键作用。尽管前列腺原发性ML的发生率较低，但通过仔细关注MRI上的特征性征象和检查结果，我们应考虑前列腺ML的鉴别诊断，其并非前列腺癌的典型表现。
