World J Mens Health.  2012 Aug;30(2):141-145.

Concurrent Bladder Lymphoma and Bladder Cancer Presenting as Metastatic Bladder Cancer

• Kim JH
• Shim JS
• Noh TI
• Ahn HJ
• Bae JH
• Park JY

Abstract

Malignant lymphoma of the bladder is a rare lesion, representing approximately 0.2% of the primary lesions and approximately 1.8% of the secondary lesions. A disseminated lymphoma presenting as a bladder mass is an infrequent phenomenon. The authors report the case of a 71-year-old patient with concurrent bladder lymphoma and bladder cancer presenting as metastatic bladder cancer. To the best of our knowledge, this is the first report of concurrent bladder lymphoma and bladder cancer.

Keyword

Urinary bladder neoplasms; Carcinoma, transitional cell; Lymphoma, non-Hodgkin

MeSH Terms

Aged
Carcinoma, Transitional Cell
Humans
Lymphoma
Lymphoma, Non-Hodgkin
Urinary Bladder
Urinary Bladder Neoplasms

Figure

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  Fig. 1 Abdominal computed tomography features of the bladder tumor. (A) A large bladder mass (black arrow) found in the base and (B) right lateral wall (white arrow) of the bladder with perivesical infiltration (asterix) and enlarged regional lymph nodes (black arrow) around the bladder.

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  Fig. 2 Cystoscopic findings of a papillary mass in the trigone (A) and left lateral wall of the bladder (B).

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  Fig. 3 Histologic features of a resection specimen of the bladder obtained from transurethral resection of the bladder tumor. The specimen showed low grade, non-invasive papillary urothelial carcinoma in the epithelium (arrow), while infiltration of atypical medium-sized to large lymphocytes showing vesicular nuclei, prominent multiple nucleoli, and an appreciable amount of basophilic cytoplasm were seen in the subepithelial connective tissue (asterisk). The atypical lymphoid cells showed more aggressive and dedifferentiated features than those of the inguinal lymph nodes (A: H&E, ×100, B: H&E, ×400).

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  Fig. 4 Histologic features of the right inguinal lymph node specimen. (A) The specimen showed a vague follicular growth pattern with relatively monotonous small lymphocytes, plasma cells, and plasmacytoid lymphocytes (H&E, ×400). (B) They were positive for immunohistochemical stains for CD20, CD79a, Bcl-2, CD43, and immunoglobulin M (IgM), but negative for CD3, CD5, Cyclin D1, CD23, and Bcl-6. The VS38 immunohistochemical stain was positive but was negative for CD138 and CD10 (Immunohistochemical examination stain or IgM, ×400).

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