Martín Oscar D, Wadskier Luis Alfredo, Quiroz Yesica, Bravo Heilen P, Cacciamani Giovanni, Umaña Paola, Medina Luis
Universidad Cooperativa de Colombia, Facultad de Medicina, Departamento de Investigación -GRIVI, Villavicencio, Colombia.
Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Servicio de Urología Bogotá, Colombia.
Ecancermedicalscience. 2017 Dec 12;11:789. doi: 10.3332/ecancer.2017.789. eCollection 2017.
This report is of a 68-year-old male patient with a three-year history of severe, progressive, low urinary tract symptoms (LUTS) with a score of 20 points on the International Symptom Scale. The patient received alpha-1-blocker therapy without adequate response. Transurethral resection of the prostate was performed, and the anatomopathological report indicated the presence of a haematolymphoid small-cell neoplasia and glandulostromal prostatic hyperplasia. Posterior immunohistochemistry evaluation reported an extra-nodal marginal zone-B lymphoma non-Hodgkin lymphoma. The patient was followed up for five years by the urology and oncology departments. In the fourth year of follow-up, the patient had B symptoms (fever, night sweats and weight loss). At the same time, laboratory tests showed haemolytic anaemia; then a new bone marrow biopsy was carried out. The histopathological specimen showed six lymphoid aggregates, constituted by a B-cell population with intra-trabecular predominance and reactivity for CD20 and BCL-2. New thoracic and abdominal computed tomographies were performed without any findings suggestive of extra-prostatic spreading. Subsequently, a chemotherapy regimen was started on the patient with the following therapeutic scheme: Rituximab 375 mg/m IV per day, cyclophosphamide 750 mg/m IV per day, Vincristine 1.4 mg/m IV dose per day and Prednisone 40 mg/m on days 1-5 (R-CVP scheme) for 21 days, until he completed six cycles. No signs, symptoms or progression have been recorded.
本报告介绍了一位68岁男性患者,有三年严重、进行性下尿路症状(LUTS)病史,国际症状量表评分为20分。患者接受α-1受体阻滞剂治疗但反应不佳。进行了经尿道前列腺切除术,解剖病理学报告显示存在血液淋巴样小细胞肿瘤和腺基质前列腺增生。后续免疫组化评估报告为结外边缘区B细胞非霍奇金淋巴瘤。泌尿外科和肿瘤科对该患者进行了五年随访。随访第四年,患者出现B症状(发热、盗汗和体重减轻)。同时,实验室检查显示溶血性贫血;随后进行了新的骨髓活检。组织病理学标本显示有六个淋巴样聚集物,由B细胞群体构成,在小梁内占优势,对CD20和BCL-2呈阳性反应。新的胸部和腹部计算机断层扫描未发现提示前列腺外扩散的任何迹象。随后,对该患者启动了化疗方案,具体治疗方案如下:利妥昔单抗375 mg/m²静脉注射每日一次,环磷酰胺750 mg/m²静脉注射每日一次,长春新碱1.4 mg/m²静脉注射每日一次,泼尼松40 mg/m²在第1 - 5天使用(R-CVP方案),持续21天,直至完成六个周期。未记录到任何体征、症状或病情进展。