膀胱淋巴組織增生引起的血尿
許智凱、張廷瑞、陳世亮
台南市立醫院 泌尿科
Bladder lymphoid hyperplasia presented with hematuria - A rare case report
Chih-Kai Hsu, Ting-Jui Chang, Shih-Liang Chen
Divisions of Urology, Tainan Municipal Hospital, Tainan, Taiwan
Background: Lymphoid hyperplasia is caused by rapid proliferation of normal cell that resembles lymph tissue. It’s more frequently occurred in GI tract but rarely seen in the urinary bladder. We presented a case that has painless hematuria as the initial symptom.
Case Report: An 81 years-old lady has HTN under regular control. She suffered from intermittent gross hematuria for 2 years. Cystoscopy was arranged 2 year ago and only some cystitis cystica was observed, Due to refractory symptoms, cystoscopy was rechecked this year. Multiple whitish nodules about 5mm with reddish rings surrounded were noted. TURBT was arranged and pathology revealed lymphoid hyperplasia. The lesions were totally resolved at the 3-month cystoscopy follow up.
Discussion: Lymphoid hyperplasia mostly occurs in all parts of the GI tract but is usually of no clinical significance. Most cases are either focal or diffuse and in the small intestine. Sometimes, it can happen in the lung, salivary gland, parotid gland, and lymph nodes. All lesions should carefully be examined and differentiated from indolent B-cell lymphoma. Microscopically, nodular lymphoid hyperplasia is a well-demarcated nodule consisting of aggregates of lymphoid follicles with reactive germinal centers and sheets of interfollicular plasma cells.
Primary malignant lymphoma of the urinary bladder is extremely rare, and benign nodular lymphoid hyperplasia has only a few cases reported. Besides nodular lymphoid hyperplasia of bladder associated with bladder carcinoma has also not been reported. The symptoms are non-specific, including hematuria and dysuria. The prognosis is excellent, since it's a benign lesion that does not recur if it is excised.