High levels of serum prostate-specific antigen due to PSA producing follicular non-Hodgkin's lymphoma
High levels of serum prostate-specific antigen due to PSA producing follicular non-Hodgkin's lymphoma
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DOI：
10.1111/j.1600-0609.2007.00883.x
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发表时间：
2007-08-01
影响因子：
3.1
通讯作者：
Wittebol, Shulamiet
中科院分区：
文献类型：
--
作者：
Oosterheert, Jan Jelrik;Budel, Leo M.;Wittebol, Shulamiet
目的：前列腺癌和非霍奇金淋巴瘤在老年患者中都很常见。血清前列腺特异性抗原（PSA）的测定是诊断和监测前列腺癌的常用工具，通常对前列腺疾病具有特异性。病例：我们描述了一个68岁的患者排尿困难和高PSA水平，但没有炎症或恶性改变，多次经直肠超声引导前列腺活检。直肠指检正常。实验室显示PSA水平明显升高（62 μ g/L, Immulight 2000 (R)）；美国DPC)。ct扫描显示右骨盆腹膜后突起伴肿块及膀胱壁浸润，提示转移性前列腺癌。手术切除腋窝淋巴结后诊断为IV期滤泡性淋巴瘤，Berard分级为I至II级，其中大多数肿瘤细胞表达PSA。经淋巴瘤特异性治疗后，正电子发射断层扫描（PET）证实完全缓解，PSA水平正常（6 μ g/L），仍持续存在。结论：虽然罕见，但高PSA水平可能是由于非霍奇金淋巴瘤的存在。当患者表现为淋巴结病而非区域性前列腺淋巴结病时，应考虑这样的诊断。
Objective: Both carcinoma of the prostate and non-Hodgkin's lymphoma are common in elderly patients. Measurement of serum prostate-specific antigen (PSA) is a frequently used tool to diagnose and monitor prostate carcinoma and is generally specific for diseases of the prostate. Case: We describe a 68-yr-old patient with voiding difficulties and high PSA levels, but without inflammatory or malignant changes upon multiple transirectal ultrasound guided prostate biopsies. Digital rectal examination was normal. Laboratory showed a strongly elevated PSA level (62 mu g/L, Immulight 2000 (R); DPC, USA). A CT-scan showed a retroperitoneal process with mass in the right pelvis and infiltration of the bladder wall, suggestive for metastatic prostate carcinoma. Surgical excision of an axillary lymph node set the diagnosis at a stage IV follicular lymphoma, Berard grade I to II in which the majority of neoplastic cells expressed PSA. After lymphoma-specific treatment, there was a positron emission tomography (PET) confirmed complete remission with normal PSA levels (6 mu g/L), which still persists. Conclusion: Although rare, high PSA levels can be due to the presence of non-Hodgkin's lymphoma. Such a diagnosis should be considered when patients present with lymphadenopathy other than regional prostatic lymphadenopathy.