膀胱腫瘤以瀰漫性大B細胞淋巴瘤呈現：案例報告
李蕎青1,2 張浚峰1,2 卓龍翔1,2 王強庭1 吳益賢1 梅健泰1 倪英睿1
國軍高雄總醫院外科部泌尿外科1三軍總醫院外科部泌尿外科2
Diffuse large B cell lymphoma in urinary bladder
Chiao-Ching Li1,2 Chun-Feng Chang1,2 Lung-Hsiang Cho1,2 Chiang-Ting Wang1 Chiang-Ting Wang1 Yi-Hsien Wu1 Ying-Jui Ni1
1Division of urology, Department of Surgery, Kaohsiung Armed Forced General Hospital
2Division of urology, Department of Surgery, Tri-Service Genereal Hospital
Abstract:
We reported the case that a 58-year-old woman presented with dysuria and urinary frequency off and on for 2 weeks. She was a cleaner of gas station for 8 years and had history of hypertension and old cerebrovascular accident without medication before. Besides, she had no habit of smoking. She came to our emergency room for treatment. Initially, pyuria(White blood count:>100 high power field(HPF), red blood cell: 2-5 HPF, Sp.gr:1.007, nitrite: negative, leukocyte ersterase: +/-) were found. In addition, the distended bladder with irregular surface about 6.4cm in length at right lateral wall and 5.2cm in length at base of bladder were revealed. Therefore, computed tomography of abdomen was arranged due to suspected bladder tumor. Soft tissue in the urinary bladder and no obvious lymph node in pelvic cavity were showed. She was admitted for further evaluation.
The cystoscopy was arranged for evaluation of suspected bladder tumor at the 2nd day after admission. The blood clot about 40ml at base of bladder and the irregular and bulging tumor in the trigone of bladder were found. Hence, the bladder biopsy and Toomey’s irrigation were performed. The pathologic finding was diffuse large B cell lymphoma (CK (-), CD3 (-), CD20 (+), chromogranin 9 (-)(Picture 5-10). And then, chemotherapy with R-CHOP regimen was performed. The symptoms got improved after 2 courses of R-CHOP regimen.