Suwa Y, Noguchi S, Sakuramoto T, Shuin T, Kinoshita Y, Kubota Y, Hosaka M
Department of Urology, Yokohama City University School of Medicine.
Hinyokika Kiyo. 1993 Dec;39(12):1171-4.
We report a case of prostatic malignant lymphoma causing bilateral hydronephrosis. A 73-year-old man was referred to our department, suffering from urinary frequency and gross hematuria. The mild elevation of serum prostatic tumor markers made us suspect prostatic carcinoma. He was admitted to our hospital and needle biopsy of the prostate was performed. Unexpectedly histological findings revealed "malignant lymphoma, diffuse large cell type". CT scan showed bilateral hydronephrosis, and renal function was decreased. As the patient suddenly vomited blood, gastric fiberscopy and biopsy was performed. Histological diagnosis of stomach was the same as for the prostate. After systemic chemotherapy of cyclophosphamide, adriamycin, vincristine, prednisone (CHOP) regimen, renal function improved and the tumor of stomach reduced, but his respiratory condition rapidly worsened, and he died about 1 month after chemotherapy. Malignant lymphoma involving the prostate is very rare. Especially in Japan only 19 cases have been reported including our case. Four of the 19 men were in their twenties and so we remind the urologists of the possibility of "malignant lymphoma of the prostate" in young patients with dysuria or frequency.
我们报告一例导致双侧肾积水的前列腺恶性淋巴瘤病例。一名73岁男性因尿频和肉眼血尿转诊至我科。血清前列腺肿瘤标志物轻度升高使我们怀疑前列腺癌。他入院后接受了前列腺穿刺活检。出乎意料的是,组织学检查结果显示为“恶性淋巴瘤,弥漫大细胞型”。CT扫描显示双侧肾积水,肾功能下降。由于患者突然吐血,遂进行了胃镜检查及活检。胃的组织学诊断与前列腺相同。采用环磷酰胺、阿霉素、长春新碱、泼尼松(CHOP)方案进行全身化疗后,肾功能改善,胃部肿瘤缩小,但他的呼吸状况迅速恶化,化疗后约1个月死亡。累及前列腺的恶性淋巴瘤非常罕见。尤其是在日本,包括我们的病例在内仅报道了19例。19名男性中有4名年龄在二十多岁,因此我们提醒泌尿外科医生,对于有排尿困难或尿频的年轻患者,要考虑到“前列腺恶性淋巴瘤”的可能性。