Primary non-Hodgkin's lymphoma of the prostate with intractable hematuria: A case report and review of the literature.
Primary non-Hodgkin's lymphoma of the prostate with intractable hematuria: A case report and review of the literature.
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DOI：
10.3892/ol.2014.2829
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发表时间：
2015-03
期刊：
影响因子：
2.9
通讯作者：
Nian Y
中科院分区：
文献类型：
--
作者：
Hu S;Wang Y;Yang L;Yi L;Nian Y
前列腺原发非霍奇金淋巴瘤的病例在全球范围内很少见。本研究报告一例前列腺弥漫性大B细胞淋巴瘤(DLBCL)合并顽固性血尿，患者为75岁男性。患者出现排尿困难和肉眼血尿。立即进行前列腺活检，然后对出血进行保守治疗。由于大出血和血压急剧下降，在局部麻醉下进行了双侧髂动脉造影和化疗栓塞术，这表明保守治疗失败。结果出血得到有效控制。前列腺活检病理检查证实存在非生发中心B细胞来源的DLBCL。免疫组织化学染色显示分化簇(CD)20(++)、CD_3(+)、白细胞共同抗原(+)、B细胞淋巴瘤-2(+)和前列腺特异性抗原(−)结果。由于患者全身状况差，血红蛋白水平低，采用小剂量利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和强的松(R-CHOP)化疗方案。经过三个疗程的化疗后，病人的病情完全缓解。结论：R-CHOP联合双侧选择性髂动脉化疗栓塞术治疗伴有顽固性血尿的前列腺非霍奇金淋巴瘤是一种安全有效的方法。
Cases of primary non-Hodgkin’s lymphoma of the prostate are globally rare. The present study reports a case of prostatic diffuse large B-cell lymphoma (DLBCL) with intractable hematuria in a 75-year-old male. The patient presented with difficulties in urination and gross hematuria. A prostate biopsy was performed immediately, followed by conservative treatment for bleeding. A bilateral iliac arteriography and chemoembolization were then performed as emergency procedures under local anesthesia due to significant bleeding and a sharply decreased blood pressure, indicating the failure of the conservative treatment. Consequently, the bleeding was effectively controlled. Pathological examination of the prostate biopsy confirmed the presence of a DLBCL of non-germinal center B-cell origin. Immunohistochemical examination demonstrated cluster of differentiation (CD)20(++), CD3(+), leukocyte common antigen(+++), B-cell lymphoma-2(+) and prostate-specific antigen(−) results. Due to the poor general condition and low hemoglobin levels of the patient, a low-dose Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy regimen was administered. Subsequent to three courses of chemotherapy, the patient achieved complete remission. In conclusion, combining R-CHOP and bilateral selective iliac arterial chemoembolization could be a safe and effective way to treat patients with non-Hodgkin’s lymphoma of the prostate and intractable hematuria.
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