Ziani Idriss, Bouaouad Majdouline, En-Nouali Hassan, Aouifi Jamal, Nouini Yassine, Aqira Aziz
Urological surgery department "A", Rabat University Hospital, Morocco Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco.
Clinical Hematology Practice, Agdal, Rabat, Morocco.
Int J Surg Case Rep. 2025 Jun;131:111360. doi: 10.1016/j.ijscr.2025.111360. Epub 2025 Apr 23.
Mantle cell lymphoma with diffuse large B cell lymphoma transformation (MCL-DLBCL) is a rare and aggressive form of lymphoma that typically presents with non-specific symptoms. It is uncommon for this lymphoma to manifest as lower urinary tract symptoms (LUTS), such as dysuria, hematuria, and pelvic pain, often leading to misdiagnosis and delayed treatment.
We present the case of a 62-year-old male patient who presented with irritative urinary symptoms. After a series of diagnostic tests, including imaging (MRI, PET-CT) and histopathological analysis, the final diagnosis was mantle cell lymphoma (MCL) with transformation into mantle cell diffuse large B-cell lymphoma (MCL-DLBCL) involving the prostate, lymph nodes, and stomach. Prostate biopsy and immunohistochemical analysis confirmed this diagnosis.
This case highlights the rare presentation of MCL-DLBCL with urinary symptoms. The role of advanced imaging techniques, such as MRI and PET-CT, in identifying the involved organs is emphasized. The study also underscores the importance of prostate biopsy and immunohistochemical analysis to confirm the diagnosis and distinguish between MCL transformation into MCL-DLBCL or a composite lymphoma. A multidisciplinary approach is crucial for early detection and proper management.
The patient received a combination of chemotherapy, including rituximab and other agents, leading to complete remission. After chemotherapy, the patient underwent autologous hematopoietic stem cell transplantation, contributing to his recovery.
伴有弥漫性大B细胞淋巴瘤转化的套细胞淋巴瘤（MCL-DLBCL）是一种罕见且侵袭性的淋巴瘤形式，通常表现为非特异性症状。这种淋巴瘤表现为下尿路症状（LUTS），如排尿困难、血尿和盆腔疼痛，较为罕见，常导致误诊和治疗延迟。
我们报告一例62岁男性患者，其表现为刺激性尿路症状。经过一系列诊断测试，包括影像学检查（MRI、PET-CT）和组织病理学分析，最终诊断为套细胞淋巴瘤（MCL）转化为套细胞弥漫性大B细胞淋巴瘤（MCL-DLBCL），累及前列腺、淋巴结和胃。前列腺活检和免疫组织化学分析证实了这一诊断。
该病例突出了MCL-DLBCL伴有尿路症状的罕见表现。强调了先进影像学技术，如MRI和PET-CT在识别受累器官方面的作用。该研究还强调了前列腺活检和免疫组织化学分析对于确诊以及区分MCL转化为MCL-DLBCL或复合性淋巴瘤的重要性。多学科方法对于早期检测和恰当管理至关重要。
患者接受了包括利妥昔单抗和其他药物的联合化疗，实现了完全缓解。化疗后，患者接受了自体造血干细胞移植，促进了康复。
