Anastasiou Ioannis, Skoufias Spyridon, Katafigiotis Ioannis, Skarmoutsos Ioannis, Constantinides Constantinos A
1st University Urology Clinic, Laiko Hospital, Athens.
Arch Ital Urol Androl. 2017 Mar 31;89(1):83-84. doi: 10.4081/aiua.2017.1.83.
Involvement of the prostate gland, as an early extra-nodal manifestation of a hematologic disease, or as a secondary infiltration is rare. Even rarer is the acute urinary retention due to infiltration by lymphocytes and simultaneously enlarged prostate. We present a case of a 61 years old male patient with a history of chronic lymphocytic leukemia, who was under oncological follow-up with no active treatment and had typical lower urinary tract symptoms due to benign prostatic hyperplasia and was receiving 5-alpha reductase inhibitor. After an acute urinary retention episode which was managed with a suprapubic catheter due to urethral catheter insertion failure, the patient was submitted to a transurethral prostatectomy. Histological examination revealed lymphocytic infiltration of the prostatic parenchyma by mostly small B cells. B-lymphocytic infiltration of the prostate gland, causes symptoms similar to benign prostatic hyperplasia. Acute urinary retention due to B-lymphocytic infiltration of the prostate is rare and the diagnosis is always histological and an oncological re-evaluation is necessary. The prognosis of these patients is related to the generalized disease rather than to the prostatic involvement.
前列腺受累作为血液系统疾病的早期结外表现或继发性浸润较为罕见。因淋巴细胞浸润且前列腺同时肿大导致急性尿潴留的情况更为罕见。我们报告一例61岁男性患者,有慢性淋巴细胞白血病病史,正在接受肿瘤学随访且未进行积极治疗,因良性前列腺增生出现典型下尿路症状,正在接受5-α还原酶抑制剂治疗。在因尿道插管失败而通过耻骨上导管处理急性尿潴留发作后,患者接受了经尿道前列腺切除术。组织学检查显示前列腺实质主要由小B细胞进行淋巴细胞浸润。前列腺的B淋巴细胞浸润会引起与良性前列腺增生相似的症状。因前列腺B淋巴细胞浸润导致的急性尿潴留罕见,诊断始终依靠组织学检查,且有必要进行肿瘤学重新评估。这些患者的预后与全身性疾病相关,而非与前列腺受累情况相关。