Genitourinary invasion by malignant lymphoma (report of 3 cases and review of the literature) / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the clinical features of genitourinary invasion by malignant lymphoma.Methods Three cases of genitourinary invasion by malignant lymphoma were reported.Case 1,a 68-year-old man,complained of right flank malaise for 1 month.CT showed a soft tissue shadow of 4.0 cm?5.5 cm with homogeneous density at right renal hilus,and diffusely thickened right greater psoas muscle at the level from lower pole of the kidney to internal iliac muscle with low-density soft tissue shadow inside.Case 2,a 72-year-old man,presented with distended left leg for 2 weeks.CT indicated left seminal vesicle mass with soft tissue density of 2.5 cm in diameter,and a soft tissue mass of 6.5 cm?4.5 cm at the left iliac artery furcation.Case 3,a 48-year-old woman,complained of fever for 1 month.CT showed well-defined,solid masses of 8.0 cm?6.0 cm and 7.0 cm?6.5 cm,respectively,in diameter with inhomogeneous density at bilateral adrenal gland areas.The incidence,clinical features,prognosis and surgical treatment of this disease were summarized in combination with review of the literature.Results All 3 cases underwent operations.The primary foci originated from pelvic or retroperitoneal lymph nodes.The kidney,seminal vesicle and adrenal gland were involved in each of the 3 cases.The pathological types were all non-Hodgkin diffusive big B cell lymphoma.One case died 2 months after operation.The other 2 received CHOP chemotherapy after operation,and were followed for 4 months and 2 years,respectively.They were both alive with no recurrence at last time of the follow-up.Conclusions Genitourinary invasion by malignant lymphoma is an uncommon disease with atypical clinical presentations and poor prognosis.Surgical treatment has little effect,while radiotherapy and chemotherapy should be the first choice.Explorative surgery has positive significance for definite diagnosis.