Lymphoma of the urinary bladder is an uncommon lesion; and its diagnostic features may not be well known by the unaccustomed practitioner. The ensuing document contains a review of the literature on lymphoma of the urinary bladder.
The key words used for the search were Lymphoma of bladder; lymphoma of urinary bladder; vesical lymphoma. Documentations from 46 sources were found which had discussed various aspects relevant to lymphoma of the urinary bladder and information from these 46 sources were used to write the literature review.
MALT lymphoma is positively stained for CD20, CD19, and it is negatively stained for CD5, CD10, and CD11c but it is positively stained for FMC7 [
Lymphomas of the urinary bladder stain negatively with Pan-keratin, vimentin, CK20, and CK7 [
urothelial carcinoma with prominent lymphoid infiltrate [ undifferentiated carcinoma [
Cohen et al. [ primary lymphoma localized to the bladder; lymphoma presenting in the bladder as the first sign of disseminated disease (nonlocalized lymphoma); recurrent urinary bladder involvement by lymphoma in patients with a history of malignant lymphoma (secondary lymphoma).
Cohen et al. [
Bates et al. [ Four patients with secondary lymphoma, for whom followup was available, had died of disease within 13 months of diagnosis. Primary lymphomas followed a more indolent course. In one case, there was evidence of transformation from low-grade MALT type to diffuse B-cell lymphoma. The most common presenting symptom was haematuria. The cystoscopic appearances were of solid, sometimes necrotic, tumours which resembled transitional cell carcinomas, and in one case the tumours were multiple.
Bates et al. [ Diffuse large B-cell lymphoma and MALT-type lymphoma are the most common primary malignant lymphomas of the bladder. Lymphoepithelial lesions in MALT-type lymphoma involve transitional epithelium, and their presence in high-grade lymphoma suggests a primary origin owing to transformation of low-grade MALT-type lymphoma. Primary and secondary diffuse large B-cell lymphomas of the bladder are histologically similar, but the prognosis of the former is favourable.
Kempton et al. [ The presenting symptoms included urinary frequency, dysuria, haematuria, and lower abdominal and back pain. Primary lymphoma was present in six patients. All were B-cell-lineage, low-grade lymphomas of the mucosa-associated lymphoid tissue (MALT) type. No patient had recurrent lymphoma or died of lymphoma. Nonlocalized bladder lymphoma occurred in 17 patients: one with low-grade lymphoma of the MALT type, four with follicle centre lymphomas, and 12 with large cell lymphomas. Excluding two patients who died postoperatively, median survival was 9 years. Six patients died of lymphoma in the follow-up period. Secondary bladder lymphoma occurred in 13 patients: two with low-grade lymphoma of the MALT type, one with follicle centre lymphoma, one with mantle cell lymphoma, and nine with diffuse large cell lymphomas. Median survival in this group was 0.6 years. Low-grade lymphoma of the MALT type was the most frequent type of primary bladder lymphoma and was associated with an excellent prognosis.
They concluded that: The bladder can be the presenting site of lymphomatous involvement in patients with more widespread disease. Survival in this group is quite favourable and is presumably dependent on lymphoma histologic type, stage of disease, and other prognostic factors. Bladder involvement by recurrent lymphoma is a sign of widely disseminated disease and is associated with a very poor prognosis.
Al-Maghrabi et al. [ All patients were older than 60 years. The male-female ratio was 1 : 3. All patients had a history of chronic cystitis. Histologic features of mucosa-associated lymphoid tissue lymphoma with centrocyte-like cells, plasmacytoid occurred. B cells or both were observed in all cases. Monoclonality of B cells was demonstrated by immunohistochemistry, polymerase chain reaction, or both methods in every case. All patients presented with stage IAE disease were treated with radiotherapy alone and had been in continuous complete remission for 2 to 13 years. On immunophenotyping, light-chain restriction was demonstrated in 3 cases (cases 2, 3, and 4) (results are summarized in Table Flow cytometric data were available for case 4 and showed typical marginal zone B-cell immunophenotype (positive for CD45 and CD20; negative for CD5, CD23, and CD10) with k light-chain restriction and an S phase of 1%, which is consistent with a low-grade lymphoma. PCR for immunoglobulin heavy-chain gene polymerase chain reaction analyses (Figure
They concluded the following. Primary bladder lymphomas are usually of low-grade mucosa-associated lymphoid tissue type. They were more common in females and had been associated with a history of chronic cystitis. Lymphoepithelial lesions were seen only in association with areas of cystitis glandularis. B-cell clonality was readily demonstrable by immunohistochemistry and/or polymerase chain reaction analysis. Local radiotherapy appeared to confer long-term control (see Figures
Clinical Summary of the four cases.
Case number | Age, years/sex | Presentation | Stage | Treatment | Follow-up years |
---|---|---|---|---|---|
1 | 64, female | Hematuria and frequency | IAE | Radiation | 13 |
2 | 69, female | Frequency and urgency | IAE | Radiation | 5 |
3 | 72, female | Hematuria and nocturia | IAE | Radiation | 3 |
4 | 62, male | Hematuria and urgency | IAE | Radiation | 2 |
Reproduced from [
Immunohistochemical and polymerase chain reaction (PCR) findings*.
Case number | CD45 | CD20 | CD45RO | CD5 | CD10 | CD43 | K & L | PCR |
---|---|---|---|---|---|---|---|---|
1 | + | + | I | ND | ND | − | I | Monoclonal |
2 | + | + | − | − | − | − | LLCR | Monoclonal |
3 | + | + | − | − | − | − | KLCR | I |
4 | + | + | − | − | − | F+ | K:CR | Monoclonal |
Reproduced from [
The microscopic feature of the second cases (haematoxylin and eosin staining). Case 2: mucosa-associated lymphoid tissue lymphoma involving the lamina propria of the urinary bladder (hematoxylin-eosin, original magnification
The microscopic feature of the second cases (haematoxylin and eosin staining). Case 2: focal lymphoepithelial lesions in area of cystitis glandularis (hematoxylin-eosin, original magnification
Case 4: B-cell-specific polymerase chain reaction using primers directed at the framework 256 (FR256) regions of the immunoglobulin heavy-chain gene (IgH). The top arrow represents the internal control that is used to ensure the presence of amplifiable DNAin each sample. The bracket in the FR256 figure denotes the size range in which IgH gene products can be seen. Although the DNA is degraded and the signal is weak, patient B (case 4) clearly shows the presence of a clonally rearranged IgH gene using the FR256 primers. Clonal rearrangements of IgH genes were also noted in cases 1 and 2 (not shown in figure). Lanes A and C are from cases unrelated to this paper. Reproduced from [
Sufrin et al. [ Direct infiltration from adjacent pelvic foci as well as discrete apparent metastatic foci was noted. Involvement was usually microscopic although the presence of gross disease was invariably clinically manifest. Cystoscopy and cystography were valuable in the diagnosis of gross lesions. In contrast to primary vesical lymphoma, the treatment of secondary vesical lymphoma was symptomatic and an operation was indicated rarely. Local radiotherapy was effective in treating the symptoms of secondary vesical lymphoma.
Kuhara et al. [ On the basis of clinicopathological features, the case resembled previously recorded cases of bladder lymphoma. The pathogenesis of the primary bladder lymphoma was presumably associated with follicular or chronic cystitis. Primary lymphoma of the bladder is a condition that is very rarely included in a series of extranodal lymphomas, and there is a curious sex difference in its occurrence rates between Japan and Western countries. Primary lymphoma of the bladder may be considered a lymphoma that originates from mucosa-associated lymphoid tissue.
Sönmezer et al. [
Primary malignant lymphoma of the urinary bladder was first described in 1885 and marked female preponderance was reported with a female to male ratio of 6.5 : 1 [
The most common types of primary lymphoma of the urinary bladder are extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT-type lymphoma) diffuse large B-cell lymphoma.
The development of lymphomas in a site normally not including lymphoid tissue was explained by the MALT concept, which was first described by Isaacson and Wright. They in 1983 [
Ohsawa et al. [ In mucosa-associated lymphoid tissue, such as neoplasms arising in indigenous lymphoid tissues, primary malignant lymphoma of the urinary bladder is a fairly uncommon disease and this accounts for 0.2% of cases with extranodal lymphoma, mostly appearing in the sixth decade. It had been stated that a significant proportion of extranodal non-Hodgkin lymphomas is known to arise from the intestine or lung, or from chronic inflammatory conditions. Since lymphoid tissue is normally not found in the urinary bladder, preexisting chronic inflammation is postulated as the origin. Nevertheless, in most of the cases, as in their case, history of chronic cystitis and histologic evidence of such an inflammation were lacking [ A review of the literature revealed that the most apparent symptoms of lymphoma of the urinary bladder are haematuria, dysuria, nocturia, urinary frequency, suprapubic or abdominal pain, weight loss, and anorexia [
Isaacson and Wright [ In their reported case, the disease (lymphoma of the bladder) presented as a pelvic mass showing strict adhesions with adjacent pelvis organs which resembled a genital cancer. But they initially thought that the patient had both a primary lymphoma of the bladder and an adnexal mass. Following an extensive work-up and histopathological evaluation of the biopsy specimen, a high-grade B-type lymphoma was diagnosed.
Lymphoma of the bladder is proposed to have characteristic cystoscopic appearance that can aid in diagnosis and is usually described as a smooth, nonulcerative, friable, or haemorrhagic submucosal tumour [
It was stated that treatment of patients with primary lymphoma of the bladder includes many options with favourable prognosis. Ohsawa et al. [ In their review of the literature, they found that multimodality therapy including surgical resection followed by chemotherapy or radiation therapy provided favourable prognosis. Only 3 of 27 patients died and 23 of 24 patients had no evidence of disease at the 31-month followup. In another review by Kempton et al. [ The extent of surgery did not seem to affect the prognosis, since a similar proportion died or had recurrence, regardless of total or partial cystectomy/resection performed [ The combination therapy including surgery and chemotherapy resulted in a 6-year disease-free survival in their patient. Based on the findings in the literature and in their case, they concluded that therapy including surgery along with radiation or chemotherapy for primary lymphoma of the bladder provides a good prognosis, even in case of a large adhesive mass.
Ando et al. [
Tsiriopoulos et al. [
Rijo et al. [
Histology of the haematoxylin-eosin-stained tissue revealed a highly cellularized tumour which displayed a diffuse, infiltrating pattern, a medullary, cohesive proliferation of medium-sized neoplastic cells, monomorphic, medium-sized cells with round nuclei, multiple nucleoli, and a basophilic cytoplasm. A “starry-sky” pattern was observed with frequent mitotic figures.
Immunohistochemical stains were negative for antibodies against CD23, CD3, CD5, bcl2, bcl6, TDT, and p53. Tumour cells were positive for CD79a, CD20, CD43, CD10, MUM1, and Ki67 (100%). Fluorescence in situ hybridization (FISH) for MYC/IGH/CEP8 revealed t(8; 14)(q24; q32). However, Epstein-Barr virus RNA was not detectable. Polymerase chain reaction (PCR) analysis was used to analyse the rearrangement of VH region genes. By amplifying the complementarity-determining region III using PCR, it was discovered that CDRIII, CDRII, and CDRI showed a clonal pattern. All of the phenotypic features mentioned supported the diagnosis of Burkitt’s lymphoma.
Based on the presumptive diagnosis of primary paraurethral Burkitt lymphoma (BL), the patient had a full workup that included a bone marrow aspirate/biopsy, viral serologies, MRI evaluation, and PET/CT to rule out metastatic origin of the paraurethral Burkitt’s lymphoma (BL). The bone marrow aspirate and biopsy revealed normocellular haematopoiesis, and no tumour cells were detected based on negative immunohistochemical analysis (CD79a, CD20, and CD3). Tumour markers and a screening test for Epstein-Barr virus, human immunodeficiency virus, hepatitis virus, and cytomegalovirus were all negative. She had magnetic resonance imaging (MRI) scan which showed a T2-weighted hypersignal at the fifth lumbar vertebra. The F-2-fluoro-D-deoxyglucose positron emission tomography CT (FDG-PET/CT) revealed increased FDG uptake in pelvic, bilateral iliac internal/external lymph nodes, and significant activity in the fifth lumbar vertebra.
The patient was referred for six cycles of immunochemotherapy: anti-CD20 (Rituximab) combined with chemotherapy (high doses of methotrexate and cytarabine with conventional cystostatics and prophylactic administration of G-CSF after chemotherapy cycles).
After the completion of the third cycle of treatment, the patient achieved near-complete remission as well as a nearly complete regression of the paraurethral tumor and the lesion of the 5th lumbar vertebra. Haematological grade 2 toxicity and gastrointestinal grade 1 toxicity were reported.
Her followup was uneventful, and at the nine-month followup a total body computed tomography (CT) scan revealed no evidence of clinical progression (either local recurrence or other distant metastasis).
The patient was still alive with a good quality of life and without clinical evidence of tumour progression.
Some authors [
Other authors stated that most frequently, genitourinary lymphoma reflects widespread metastasis which was caused by a systemic haematological disease [
Burkitt’s lymphoma (BL) was first described in 1958 in Uganda by a surgeon who observed children with rapidly enlarging tumours which involved the jaw. Since then, Burkitt’s lymphoma (BL) has been categorized by the World Health Organization (WHO) into three types which include the endemic type, the sporadic type, and the immunodeficiency-associated types [
It has been stated that the endemic form of Burkitt’s lymphoma is found mostly in equatorial Africa and in Papua New Guinea and this form of Burkitt’s lymphoma is associated with the Epstein-Barr virus in 95% of cases. The sporadic (or American) form of Burkitt’s lymphoma is found in North America, Northern and Eastern Europe, and the Far East and this form of Burkitt’s lymphoma is associated with the Epstein-Barr virus in 15% of patients. The immunodeficiency associated form of Burkitt’s lymphoma occurs mainly in patients with HIV, but it can also occur in allograft recipients and patients with congenital immunodeficiencies or X-linked lymphoproliferative disease [
It was also stated that: Even though Burkitt’s lymphoma can involve the head and neck in children, the gastrointestinal tract, genitourinary tract, gonads, mesentery, peritoneum, and retroperitoneum also represent potentially affected sites. Lymphomas arising in the male genitourinary tract are relatively uncommon. Malignant lymphoma involving the prostate is rare and accounts for less than 0.1% of newly diagnosed lymphomas.
The most frequent presentation forms are obstructive urinary symptoms. [
Some authors [ Bladder outlet obstruction in women is an infrequently diagnosed urological condition. A combination of history taking; physical examination; and diagnostic tests provides a consistent way to accurately recognize and diagnose bladder outlet obstruction.
The causes of obstruction are varied and numerous but generally fall within two broad categories: functional and anatomic. In a fertile female, the most likely anatomic causes of bladder outlet obstruction symptoms are bladder and urethral leiomyoma, and an association with female hormone expression has been suggested previously [
Other differential diagnoses include urethral caruncle, urethral diverticulum [
Rijo et al. [ The diagnosis of Burkitt’s lymphoma depends upon morphological findings, immunophenotyping results, and cytogenetic features. Because this lymphoma is one of the most rapidly proliferating neoplasms and is often associated with tumour lysis syndrome, a prompt diagnosis is required. Treatment of Burkitt’s lymphoma is inclusive of high doses of alkylating agents, frequent administration of chemotherapy, and attention to central nervous system (CNS) prophylaxis with high doses of systemic chemotherapy, intrathecal therapy, or both. There is no role for radiation therapy in the modern treatment of Burkitt’s lymphoma—even for localized disease or para—spinal presentations, which respond very quickly to chemotherapy. To their knowledge, their reported case of female paraurethral Burkitt’s lymphoma was the first case of primary paraurethral female Burkitt’s lymphoma not related to Epstein-Barr virus which was reported in the literature.
Thomas et al. [
Mourad et al. [
Wang et al. [
Oh and Zang [
Sundaram and Zhang [ Primary lymphoma of the bladder is rare and primary Epstein-Barr virus (EBV) + lymphoproliferative disorder (LPD) of the bladder had not been previously described. Potential misdiagnosis of poorly differentiated urothelial carcinoma can occur and accurate diagnosis depends upon comprehensive immunohistochemical and molecular work-ups [
Abraham Jr. et al. [
Hayashi et al. [
Siegel and Napoli [
Kakuta et al. [
Takahara et al. [
Terasaki et al. [
Raderer et al. [ A total of 170 cycles were administered to their patients (median 6, range 2 to 8). Twenty of the 26 patients (77%) achieved a complete remission and 6 (23%) a partial remission. Toxicities were mainly haematological, with WHO grade III/IV leukocytopenia occurring in 5 patients. After a median followup of 19 months (range 10 months to 45 months), all patients were alive: 22 were in ongoing remission, while 4 had relapsed between 12 and 19 months after treatment.
Raderer et al. [
Finally, Tables
Some of the reported cases of lymphoma of the urinary bladder mainly primary with other cases of paraurethral lymphoma, their management and outcome.
References of cases | Treatment types | Follow-up duration | Complete remission | Partial remission | No response | Total sex/age histology |
---|---|---|---|---|---|---|
Raderer et al. [ |
RCHOP or RCNOP |
19 months mean |
20 (77%) | 6 (23%) | 0 | 26 patients with MALT lymphoma of bladder |
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Terasaki et al. [ |
Radiotherapy Gy 26 and Rituximab chemotherapy after remission | 14 months | 1 patient | 1 female aged 64 years with MALT lymphoma of bladder | ||
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Takahara et al. [ |
TURBT and Radiotherapy 40 Gy in 20 fractions | 3 monthly intervals to, duration is not available to author | 1 patient | 1 female aged 85 years with extranodal marginal zone B-cell lymphoma | ||
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Kakuta et al. [ |
Rituximab in combination with CHOPP chemotherapy after transurethral biopsy | Duration is not available to author | 1 patient | 1 female aged 84 years with extranodal marginal zone B-cell lymphoma of bladder | ||
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Siegel and Napoli [ |
Extensive resection | Duration is not stated | Alive, but outcome with regard to response is not available to author | Alive, but outcome with regard to response is not available to author | 1 elderly female with B-cell lymphoma of dome of bladder with signet ring cell component | |
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Hayashi et al. [ |
3 courses of R CHOPP chemotherapy | Duration is not available to author | 1 patient | 1 female age not available to author with DCBCL (primary diffuse large B-cell lymphoma of urinary bladder) | ||
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Abraham et al. [ |
Resectional biopsy and non-Hodgkin’s lymphoma therapy | Duration is not stated | 1 | 1 female aged 72 years with extranodal monocytoid B-cell lymphoma (MBCL) derived from marginal zone lymphocyte | ||
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Sundaram and Zhang [ |
Resection but details of further management not available | Details is not available to author | 1 female aged 67 years with localized Epstein-Barr virus (EBV) positive B-cell lymphoproliferative disorder (LPD)/polymorphous B-cell lymphoma of the bladder | |||
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Oh and Zang [ |
Transurethral resection biopsy and two cycles of systemic cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOPP) chemotherapy | Duration is not stated | 1 patient with simultaneous restoration of urinary function | 1 male aged 35 years with diffuse large B-cell lymphoma (non-Hodgkin’s lymphoma) | ||
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Wang et al. [ |
TURBT and four cycles of CHOPP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy | 12 months | 1 with good response and remained in clinical remission for 12 months after treatment | 1 male aged 45 years with T-cell lymphoma of urinary bladder | ||
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Mourad et al. [ |
Transurethral resection biopsy of lesion and |
Duration not available to author: appeared case was reported earlier without details of long-term follow-up | Response not available | 1 male aged 52 years who had shistosomiasis and found to have T-cell lymphoma of urinary bladder which Mourad et al. [ | ||
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Ando et al. [ |
Transurethral resection of bladder tumour only | 3 years | 1 | 1 female aged 77 years with primary low-grade B-cell lymphoma of the MALT type | ||
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Simpson et al. [ |
Details not available to author | Details are not available to author | Details not available to author | — | — | 1 female with T-cell primary lymphoma of bladder and urethra |
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Mearini et al. [ |
Transurethral resection of bladder tumour (Burkitt’s lymphoma) plus subsequent antiretroviral treatment with stavudine (40 mg twice daily), lamivudine (150 mg twice daily), and nelfinavir (750 mg 3 times daily), as well as antitumour polychemotherapy (4 cycles of cyclophosphamide, vincristine, doxorubicin, and dexamethasone, alternated with 4 cycles of methotrexate and cytarabine) | 8 months of followup | Complete resolution and biopsy of small mucosal lesion at site of previous tumour 8 months later only showed fibrous tissue on immunohistochemical and histological examination | 27-year-old man with Burkitt’s lymphoma | ||
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Tsiriopoulos et al. [ |
Cystectomy and ileal conduit after failure of conservative treatment for presumed interstitial cystitis | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | 75-year-old patient with past history of chronic lymphatic leukaemia histology of bladder showed primary splenic marginal zone lymphoma simulating interstitial cystitis |
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Downs et al. [ |
Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | They concluded that primary lymphoma of the bladder has a good prognosis and responds to a variety of therapeutic modalities |
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Simpson et al. [ |
3 cases | 7 years. |
Alive and free of tumour. |
A 70-year-old man with low grade type | ||
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Isaacson and Wright [ |
2 cases, details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author |
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Ohsawa et al. [ |
3 cases, details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author |
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Sönmezer et al. [ |
Transurethral biopsy, partial cystectomy, total hysterectomy, bilateral oophorectomy, and four courses of CHOP regimen (cyclophosphamide, vincristine, doxorubicin, and prednisolone) | 6 years | Alive and well with no local recurrence of distant metastasis | 1 female aged 50 years with high-grade B-cell lymphoma | ||
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Kuhara et al. [ |
Details of duration of followup are not available to author | Outcome is not available to author | Outcome is not available to author | Diffuse B-cell lymphoma of medium-sized cell | ||
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Sufrin et al. [ |
13% of 599 patients with malignant lymphoma had secondary bladder involvement and were treated with local radiotherapy | 1952 to 1972 | Good response | 13% of 599 patients with secondary bladder lymphoma (details of the various types are not available to author) | ||
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Cohen et al. [ |
Details of case are not available to author | Details of case are not available to author | Details of case are not available to author | Details of case are not available to author | Details of case are not available to author | 1 case of primary B-cell lymphoma of bladder |
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Zukerberg et al. [ |
5 cases (diagnosis of malignant lymphoma was excluded in 1 leaving 4 as lymphoma of T-cell type |
4 |
1 alive with no tumour after 4 years following radiotherapy. and chemotherapy. |
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Al-Maghrabi et al. [ |
Radiotherapy (35 Gy) | 13 years, |
Alive no recurrence. |
64-year-old female,stage IAE | ||
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Mantzarides et al. [ |
Details of treatment are not available to author | Further details are not available to author | Further details are not available to author | Further details are not available to author | Further details are not available to author | 82-year-old female with primary diffuse large B-cell lymphoma of the bladder wall |
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Evans and Moore [ |
Transurethral biopsy of bladder tumour and she received a course of R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab) chemotherapy | 4 months | CT scan showed regression of lesion and symptomatic improvement | 64-year-old female with histologically proven diffuse large B-Cell non-Hodgkin’s lymphoma (primary) | ||
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Arda et al. [ |
Open biopsy; she refused surgical operation and was referred to oncologist for chemotherapy | Further details are not available to author | Further details are not available to author | Further details are not available to author | Further details are not available to author | 54-year-old female had open biopsy proven to be malignant non-Hodgkin’s lymphoma |
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Aceñero, et al. [ |
Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | Details are not available to author | 3 cases of primary malignant lymphoma of urinary bladder (2 of high grade) of MALT type |
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Jacobs and Symington [ |
Cystectomy | 3 years | Alive and well with no recurrence of locally or distant metastasis | 61-year-old woman with primary lymphoma of urinary bladder | ||
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Diaz-Peromingo et al. [ |
TUR biopsies and CNOP (cyclophosphamide, mitoxantrone, vincristine, and prednisolone) and monoclonal antibodies anti-CD20 | Short period of follow-up case reported shortly after initial treatment | Good initial response | 79-year-old man tumour B-cell lymphoma (non-Hodgkin’s) which was initially thought to be primary; however, PER scan confirmed that it was a secondary bladder lymphoma | ||
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Rijo et al. [ |
Open per vaginal partial excision of paraurerethal lesion. extending to the trigone of the bladder (this was a paraurethal lesion not a bladder lesion). |
9 months | 1 | 1 female aged 27 years |
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Hatano et al. [ |
Transurethral resection of bladder tumour and left total nephroureterectomy; histology adenocarcinoma G2pT2 in renal pelvis and MALT-type lymphoma of bladder; radiotherapy 36 Gy to bladder | 14 months | Alive with no evidence of recurrence | 84-year-old with MALT-type lymphoma of bladder and adenocarcinoma of left renal pelvis |
List of some of the reported studies on lymphoma of the urinary bladder with outcome.
References | Types and numbers of lymphomas of the urinary bladder | Types of management | Duration of followup | Outcome | Total |
---|---|---|---|---|---|
Bates et al. [ |
|
Various details are not available |
1 year | Indolent course with good prognosis |
1 |
79 years/female |
No followup | Unknown |
1 | ||
59 years female T2-T3 low grade MALT type | Alive with disease | 1 | |||
84 years/female, T3 diffuse large B-cell lymphoma | 3 years |
Died of disease after 6 months | |||
67/years male, Solid tumour diffuse large B-cell lymphoma, had radiotherapy and chemotherapy | 16 years | Alive with disease after 16 years | |||
80 years/female |
3 years 8 months | Alive and well after 3 years 8 months | |||
|
Various details are not available to author |
4 patients had followup up to 13 months |
4 patients died within 13 months of followup | ||
65-year-old male laparotomy showed mass involving ileum and generalised lymphadenopathy. Diffuse large B-cell lymphoma secondary to systemic follicular lymphoma | 13 months |
Died of disease after 13 months |
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41 years/male |
Radiotherapy and chemotherapy | 10 months | |||
32 years/male, necropsy showed abdominal mass and lymphadenopathy. Diffuse large B-cell lymphoma | Died of disease. |
Died of disease. |
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76/female, mass in lower abdomen, swollen left leg, lymphadenopathy in left groin, and right axilla. Diffuse large B-cell lymphoma |
1 month |
No follow-up | |||
Disease developed to nodular sclerosis Hodgkin’s disease of bladder | |||||
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Kempton et al. [ |
Primary B-cell MALT-type lymphoma of bladder in 6 patients |
Various | 1940 to 1996 | Complete remission. No patient died and no patient developed recurrent disease. |
6 patients |
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Al-Maghrabi et al. [ |
4 cases of primary lymphoma |
All patients were treated by radiotherapy | 2 to 13 years | Good prognosis (all the four with no recurrence and alive) | 4 patients |
Lymphoma of the urinary bladder may be either primary or secondary lymphoma.
Diagnosis of lymphoma of the urinary bladder is based upon the characteristic morphology of the bladder lesion which has been resected or biopsied and this must be supported by immunohistochemical analysis.
Lymphoma of the urinary bladder is a rare lesion.
Radiotherapy and chemotherapy are useful and effective in the treatment of lymphoma of the urinary bladder.
The author declares that there is no conflict of interests.
Thanks are due to the Editor-in-Chief of Archives of Pathology and Laboratory Medicine for granting the author permission on behalf of the editorial team of the journal and the American Association of Pathology to use figures and tables from [