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社区医院 20 年泌尿生殖系统淋巴瘤诊治经验。

Twenty-year Experience with Genitourinary Lymphoma at a Community Hospital.

机构信息

Department of Medical Education, Gundersen Health System, La Crosse, Wisconsin, USA; Current Affiliation: Thedacare Regional Cancer Center, Appleton, Wisconsin, USA.

Department of Medical Education, Gundersen Health System, La Crosse, Wisconsin, USA; Current Affiliation: Hematology/Oncology Fellow at University of Iowa Health Care, Iowa City, Iowa, USA.

出版信息

Clin Med Res. 2021 Jun;19(2):72-81. doi: 10.3121/cmr.2021.1531. Epub 2021 Mar 31.

Abstract

Non-Hodgkin lymphoma is the seventh most common cancer in the United States. It may involve any extranodal organ, although involvement of the genitourinary (GU) tract accounts for <5% of all primary extranodal lymphomas. Published GU lymphoma literature is currently limited to small case series and case reports. The last substantial American series was published in 2009. Our objective was to characterize cases of GU lymphoma from our institution based on organ involved and to review relevant literature. After institutional review board approval, we retrospectively reviewed medical records of patients diagnosed with lymphoma involving the GU organs from 1995 through 2015. Patients with obstructive uropathy from retroperitoneal adenopathy without parenchymal involvement of a GU organ were excluded. We classified extranodal GU lymphomas as primary or secondary, based on involvement of other organs and distant lymphadenopathy. Thirty-six patients had lymphoid neoplasms involving the kidney, ureters, bladder, testis, penile skin, or prostate in our health system during the study period. Of these, 15 (41.6%) were primary. Most patients initially sought consultation for GU-related symptoms, such as bladder obstruction, hematuria, testicular mass, or abdominal pain. Histological subtypes and flow cytometry findings varied broadly. Our series reports site-specific outcomes data and adds detail to findings from other published series. Although GU lymphomas are rare, our series confirms prior studies demonstrating presentation in urologic organs. They should be considered in the differential diagnosis in all patients, especially those with unusual findings on examination, cystoscopy, or computed tomography scan.

摘要

非霍奇金淋巴瘤是美国第七大常见癌症。它可能涉及任何结外器官,尽管泌尿生殖系统(GU)受累占所有原发性结外淋巴瘤的<5%。已发表的 GU 淋巴瘤文献目前仅限于小型病例系列和病例报告。最后一次重要的美国系列研究发表于 2009 年。我们的目的是根据受累器官对我院的 GU 淋巴瘤病例进行特征描述,并复习相关文献。在机构审查委员会批准后,我们回顾性地审查了 1995 年至 2015 年期间我院诊断为 GU 器官受累的淋巴瘤患者的病历。排除了因腹膜后淋巴结病引起的尿路梗阻而无 GU 器官实质受累的患者。我们根据其他器官受累和远处淋巴结病将结外 GU 淋巴瘤分为原发性或继发性。在研究期间,我们的医疗系统中有 36 例患者的肾、输尿管、膀胱、睾丸、阴茎皮肤或前列腺存在淋巴肿瘤。其中 15 例(41.6%)为原发性。大多数患者最初因 GU 相关症状就诊,如膀胱梗阻、血尿、睾丸肿块或腹痛。组织学亚型和流式细胞术结果广泛多样。我们的系列报告了特定部位的预后数据,并为其他已发表的系列研究提供了详细信息。尽管 GU 淋巴瘤很少见,但我们的系列研究证实了先前的研究结果,即 GU 器官受累。在所有患者中,特别是在体格检查、膀胱镜检查或计算机断层扫描检查发现不寻常结果的患者中,应考虑将其作为鉴别诊断。

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