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Diffuse large B-cell lymphoma of the prostate.

Joshua I Warrick1, Scott R Owens, Scott A Tomlins

  • 1From the Department of Pathology (Drs Warrick, Owens, and Tomlins), Michigan Center for Translational Pathology (Dr Tomlins), Department of Urology (Dr Tomlins), and Comprehensive Cancer Center (Dr Tomlins), University of Michigan Medical School, Ann Arbor.

Archives of Pathology & Laboratory Medicine
|October 1, 2014
PubMed
Summary

Prostate lymphomas are rare, often secondary to nodal lymphoma. This case highlights diffuse large B-cell lymphoma presenting as a high-grade malignancy, emphasizing the need for accurate diagnosis in prostatic neoplasms.

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Area of Science:

  • Uropathology
  • Hematopathology
  • Oncology

Background:

  • Prostatic lymphomas are uncommon, typically representing secondary involvement rather than primary tumors.
  • Diffuse large B-cell lymphoma (DLBCL) is a high-grade malignancy that can involve the prostate.
  • Chronic lymphocytic leukemia/small lymphocytic lymphoma is the most frequent subtype encountered in prostatic tissues.

Observation:

  • A 46-year-old male presented with lower urinary tract obstruction due to a high-grade malignancy on prostate biopsy.
  • Morphologic and immunohistochemical analyses confirmed diffuse large B-cell lymphoma of the prostate.
  • Positron emission tomography-computed tomography revealed widespread disease, including mediastinal lymphadenopathy, osseous metastases, and involvement of the pancreas, prostate, and bladder.

Findings:

  • The patient's presentation and imaging suggested secondary prostatic involvement by a primary nodal lymphoma.
  • The case underscores the importance of considering lymphoma in the differential diagnosis of high-grade prostatic malignancies.
  • Diagnostic workup involved prostate biopsy, morphologic evaluation, immunohistochemistry, and advanced imaging.

Implications:

  • Accurate differentiation of prostatic lymphoma from primary prostate cancer is critical for appropriate treatment and patient management.
  • This case highlights the diagnostic challenges and systemic nature of prostatic lymphomas.
  • Further research into the pathogenesis and optimal treatment strategies for prostatic lymphomas is warranted.