泌尿系統原發性B細胞淋巴癌 – 5位病人病例報告
陳柏華、嚴孟意、林介山、王百孚、江恆杰
彰化基督教醫院 外科部 泌尿科
Primary B-Cell Lymphoma of Genitourinary tract – Case series of 5 patients
Pao-Hwa Chen, Meng-Yi Yan, Jesen Lin, Bai-Fu Wang, Heng-Chieh Chiang
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Purpose:
Primary lymphoma of genitourinary tract accounts for less than 0.2% of all extra-nodal lymphomas. We retrospectively collected 5 cases of primary GU lymphoma and analyzed the outcome.
Materials and Methods:
We retrospectively searched for lymphoma cases in GU tract with ICD code for lymphoma and limiting to GU service patients. We were able to identify 5 patients with primary lymphoma of GU tract. Three patients expired, one is still under OPD followup, and one losted followup. Four patient had lesions in bladder while one is located at prostate. The average survival is 30 months, with range of 7 to 72 months. Our longest survival patient was diagnosed in 2006 of prostate B-cell lymphoma and the last known OPD followup was in 2012. All of our patients were diagnosed with either cystoscopy biopsy or prostate biopsy and bone marrow biopsy was done to determine the site of primary lymphoma. All of our patients had normal bone biopsy results. Two patients underwent CCRT while the other 3 underwent either chemo or radio-therapy alone. Lymphoma grade and CCRT seem to be related to survival benefits, but due to the limited amount of patients it will be hard to determine. The longest survival patient had either low grade lymphoma or underwent CCRT (40 and 72 months respectively).
Conclusion and discussion:
In terminal non-Hodgkin’s lymphoma patients, secondary involvement of genitourinary tract occurs in about 10 to 20% of NHL cases. Most common sites of extra-nodal lymphomas arise in stomach, soft tissues or skin. On the other hand, primary lymphoma of urinary bladder, which accounts for less than 0.2% of all extra-nodal lymphomas, has less than 100 reported cases in English literatures. Due to the limited number of reported cases of primary urinary bladder lymphoma, there are no guidelines or set treatment plans for this disease. Upon reviewing previous reported cases of bladder and prostate lymphoma, radiation and chemotherapy showed good remission results in subsequent follow-up images. More cases and longer follow-up periods are needed to determine the long-term remission rate for these non-surgical treatments.