泌尿生殖系統淋巴瘤之診斷、治療與臨床建議：系統性文獻回顧

陳曉芳¹、蕭亞芝¹、鄭如惠²、黃品叡^3,4,5

1李綜合醫療社團法人苑裡李綜合醫院 醫療部 專科護理師小組

2李綜合醫療社團法人苑裡李綜合醫院 護理部

3李綜合醫療社團法人大甲李綜合醫院 外科部 泌尿外科

4國立陽明交通大學 跨領域醫學博士學位學程

5亞洲大學 食品營養與保健生技學系

Diagnosis, Management, and Clinical Recommendations for Lymphoma Involving the Genitourinary System: A Systematic Review

Hsiao-Fang Chen¹, Ya-Chih Hsiao¹, Ru-Hui Cheng², Pin-Jui Huang^3,4,5

1Division of Nursing Participants, Department of Medical Affairs, Yuanli Lee Hospital

2Nursing Department, Yuanli Lee Hospital

3Division of Urology, Department of Surgery, Dajia Lee Hospital

4Ph.D. Program in Interdisciplinary Medicine, National Yang Ming Chiao Tung University, Taipei

5Department of Food Nutrition and Health Biotechnology, Asia University, Taichung

Introduction:

Lymphoma involving the genitourinary (GU) system is rare and often presents with nonspecific symptoms, making diagnosis challenging and frequently delayed. Both primary and secondary involvement of organs such as the kidney, bladder, prostate, and testis have been reported. Due to its rarity, there is no standardized management guideline specifically for GU lymphoma. This systematic review aims to summarize current evidence regarding diagnosis, treatment strategies, and clinical recommendations for lymphoma involving the genitourinary tract.

Materials and Methods:

A systematic literature review was conducted using PubMed, Embase, and Cochrane Library databases for studies published between 2000 and 2025. Keywords included “genitourinary lymphoma,” “renal lymphoma,” “bladder lymphoma,” “prostate lymphoma,” and “testicular lymphoma.” Studies discussing clinical presentation, diagnostic methods, treatment modalities, and outcomes were included. Case reports, retrospective studies, and review articles were analyzed.

Results:

Genitourinary lymphoma most commonly involves the kidney and testis, followed by the bladder and prostate. Clinical presentation often mimics more common urologic malignancies, including hematuria, flank pain, lower urinary tract symptoms, or painless testicular enlargement. Imaging findings are nonspecific, and definitive diagnosis relies on histopathological examination and immunohistochemistry. Diffuse large B-cell lymphoma is the most common histological subtype. Systemic chemotherapy, particularly rituximab-based regimens such as R-CHOP, remains the mainstay of treatment. Surgical intervention is mainly diagnostic rather than therapeutic in most cases, except for testicular lymphoma where orchiectomy is often performed. Early systemic therapy is associated with improved outcomes compared to surgery alone.

Discussion:

Due to the rarity and nonspecific presentation of GU lymphoma, urologists play an important role in early recognition and biopsy for diagnosis. Radical surgery should be avoided when lymphoma is suspected, as systemic therapy is the primary treatment modality. Multidisciplinary collaboration between urologists, hematologists, and oncologists is essential for optimal patient management.

Conclusion:

Genitourinary lymphoma is a rare but important differential diagnosis of urologic tumors. Early biopsy and histological confirmation are critical to avoid unnecessary radical surgery. Systemic chemotherapy remains the cornerstone of treatment. Clinicians should consider lymphoma in atypical urologic tumors to ensure timely diagnosis and appropriate management.