Tani Masaru, Tsutahara Koichi, Inoguchi Shunsuke, Oka Toshiki, Asakura Toshihisa, Kawamura Norihiko, Ishiko Jun, Nakagawa Masahiro, Nakagawa Masashi, Takao Tetsuya, Yamaguchi Seiji
The Department of Urology, Osaka General Medical Center.
The Department of Hematology/Oncology, Osaka General Medical Center.
Hinyokika Kiyo. 2020 Nov;66(11):397-401. doi: 10.14989/ActaUrolJap_66_11_397.
An 84-year-old man consulted a local physician for asymptomatic macrohematuria. Abdominal ultrasonography revealed thickening ofthe bladder wall from the triangular part ofthe bladder to the posterior wall, and he was referred to our department. Cystoscopy showed extensive bladder wall thickening with edema ofthe mucosa. Abdominal contrast-enhanced computed tomography (CT) showed extensive bladder wall thickening and right external iliac lymphadenopathy accompanied by a contrast effect suspected ofbeing extravesical invasion. We performed transurethral resection ofthe bladder tumor and made the diagnosis ofmucosa associated lymphoid tissue (MALT) lymphoma. Our diagnosis made from positron emission tomography-CT performed after surgery was primary MALT lymphoma of the bladder and metastasis to the right external iliac lymph node. We administered rituximab 375 mg/m2 once a week for four times in total. CT after rituximab administration showed that the tumor and right external iliac lymph nodes had shrunk significantly, and no recurrence was present at 18 months after treatment.
一名84岁男性因无症状性肉眼血尿咨询当地医生。腹部超声检查显示膀胱壁从膀胱三角区至后壁增厚,随后他被转诊至我科。膀胱镜检查显示膀胱壁广泛增厚,黏膜水肿。腹部增强计算机断层扫描(CT)显示膀胱壁广泛增厚及右侧髂外淋巴结肿大,并伴有疑似膀胱外侵犯的强化效应。我们进行了经尿道膀胱肿瘤切除术,诊断为黏膜相关淋巴组织(MALT)淋巴瘤。术后正电子发射断层扫描-CT诊断为原发性膀胱MALT淋巴瘤并转移至右侧髂外淋巴结。我们给予利妥昔单抗375 mg/m²,每周1次,共4次。利妥昔单抗治疗后的CT显示肿瘤及右侧髂外淋巴结明显缩小,治疗后18个月无复发。