Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Lin-Kou Branch, Taiwan.
Department of Obstetrics and Gynecology, Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan.
Taiwan J Obstet Gynecol. 2021 Sep;60(5):920-923. doi: 10.1016/j.tjog.2021.07.025.
We report a case of diffuse large B-cell urethral lymphoma initial presenting with non-healing urethra ulcer.
A 68-year-old woman presented with a non-healing urethral ulcer accompanied with vulvar pruritus, which failed to medical treatment. Her medical history was unremarkable, lacking fever, weight loss or unexplained fatigue. There were no enlarged lymph nodes or palpable liver or spleen upon physical examination. Pelvic examination revealed an ulcerative lesion arising from the posterior wall of the urethral meatus. Cystourethroscopy showed no bladder involvement. Surgical excision of the urethral ulcer was done and immunohistochemical report showed a diffuse large B-cell lymphoma. Bone marrow needle biopsy and computed tomography were done and the diagnosis of primary diffuse large B-cell urethral lymphoma stage IEA was made. She underwent six cycles of cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab and was free of disease for 51 months.
This report of urethral lymphoma was presented as a non-healing ulcer initially, which was totally different previous reports, presenting with bleeding, either vaginal or urinary, urinary frequency, dysuria, urine retention and self-perceived mass, suggesting that unhealed ulcer on the perineal area should be promptly evaluated and avoidance of unnecessary delayed therapy for possible curable disease.
我们报告一例以尿道溃疡经久不愈为首发表现的弥漫性大 B 细胞尿道淋巴瘤。
一名 68 岁女性因尿道溃疡伴外阴瘙痒而就诊，溃疡经久不愈，经药物治疗无效。患者既往无特殊病史，无发热、体重减轻或不明原因的疲劳。体格检查未触及淋巴结肿大，肝脾无触痛。盆腔检查发现尿道舟状窝后壁有一溃疡性病变。膀胱镜检查未见膀胱受累。行尿道溃疡切除术，免疫组化报告显示弥漫性大 B 细胞淋巴瘤。行骨髓针吸活检和计算机断层扫描，诊断为原发性弥漫性大 B 细胞尿道淋巴瘤 IEA 期。患者接受了六个周期的环磷酰胺、多柔比星、长春新碱、泼尼松和利妥昔单抗治疗，51 个月后无病生存。
本报告的尿道淋巴瘤最初表现为经久不愈的溃疡，与既往报道的以出血（阴道或尿道）、尿频、尿痛、尿潴留和自我感知肿块为主要表现的病例不同，提示会阴部经久不愈的溃疡应及时评估，避免因可能可治愈的疾病而延误不必要的治疗。
