Incidental and concurrent malignant lymphomas discovered at the time of prostatectomy and prostate biopsy - A study of 29 cases
Incidental and concurrent malignant lymphomas discovered at the time of prostatectomy and prostate biopsy - A study of 29 cases
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DOI：
10.1097/01.pas.0000153122.65138.b1
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发表时间：
2005-05-01
影响因子：
5.6
通讯作者：
Weiss, LM
中科院分区：
文献类型：
--
作者：
Chu, PGG;Huang, Q;Weiss, LM
在前列腺活检、经尿道切除术和前列腺切除术时发现的恶性淋巴瘤的发病率和组织学特征没有很好的文献记载。我们检索了从1989年到2004年的前列腺手术标本中发现的恶性淋巴瘤的外科病理学文件。在此期间，在City of Hope检查的4，831例前列腺标本中（3，405例活检，266例经尿道切除术，1，160例经尿道切除术），确定了29例涉及前列腺和盆腔淋巴结的恶性淋巴瘤（0.6%）。这些恶性淋巴瘤可分为两组：1）18例（0.37%）无恶性淋巴瘤既往史的偶发病例; 2）11例（0.23%）伴发已知恶性淋巴瘤。对于第一组，盆腔淋巴结受累患者的年龄范围为59至78岁（平均69.2岁;中位数70岁），前列腺受累患者的年龄范围为45至78岁（平均64.6岁;中位数67.5岁）。第二组患者的年龄范围为53 - 80岁（平均66.8岁，中位数69岁）。所有病例均经免疫组化或分子生物学分析确诊。第一组18例中10例仅累及盆腔淋巴结，另8例为原发性前列腺淋巴瘤。第一组18例中13例为小淋巴细胞淋巴瘤/慢性淋巴细胞白血病（SLL/CLL），3例为边缘区B细胞淋巴瘤，1例为套细胞淋巴瘤。这些淋巴瘤在大多数情况下组织学检查不明显，当前列腺受累时可能与慢性前列腺炎混淆，当盆腔淋巴结受累时可能与反应性淋巴增生混淆。免疫组织化学和分子生物学研究可能是必要的，以确认诊断。对于第二组，前列腺和盆腔淋巴结受累作为并发恶性淋巴瘤全身播散的一部分。在这些病例中，诊断通常很容易确定。其中SLL/CLL 4例，滤泡性淋巴瘤4例，套细胞淋巴瘤2例，弥漫性大B细胞淋巴瘤1例。
The incidence and histologic features of malignant lymphomas discovered at the time of prostate biopsy, transurethral resection, and prostatectomy are not well documented. We searched our surgical pathology files for malignant lymphomas identified from prostate surgical specimens from 1989 to 2004. Of 4,831 cases of prostate specimens (3,405 biopsies, 266 transurethral resections, 1, 160 prostatectomies) examined at the City of Hope during this period, 29 cases of malignant lymphomas involving the prostate and pelvic lymph nodes were identified (0.6%). These malignant lymphomas can be divided into two groups: 1) 18 incidental cases (0.37%) without prior history of malignant lymphoma; and 2) 11 cases (0.23%) with concurrent known malignant lymphoma. For the first group, the patients with pelvic node involvement ranged in age from 59 to 78 years (mean, 69.2 years; median, 70 years), and the patients with prostate involvement ranged in age from 45 to 78 years (mean, 64.6 years; median, 67.5 years). For the second group, the patients ranged in age from 53 to 80 years (mean, 66.8 years; median, 69 years). Diagnoses of all cases were confirmed by immunohistochemistry or molecular analysis. Ten of 18 cases in the first group involved pelvic nodes only, and the other 8 cases were primary prostatic lymphoma. Of 18 cases in the first group, 13 were small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL), 3 were marginal zone B-cell lymphoma, and I was mantle cell lymphoma. These lymphomas were not readily apparent in most cases by histologic examination, and may be confused with chronic prostatitis when the prostate was involved or with reactive lymphoid hyperplasia when pelvic nodes were involved. Immunohistochemistry and molecular studies may be necessary to confirm the diagnosis. For the second group, prostate and pelvic lymph nodes were involved as part of systemic dissemination of concurrent malignant lymphoma. The diagnosis was usually easily established in these cases. Of I I cases, 4 were SLL/CLL, 4 were follicular lymphoma, 2 were mantle cell lymphoma, and I was diffuse large B-cell lymphoma.