Primary prostatic lymphoma in a young male with hiv infection.

Primary lymphoma involving the prostate gland is rare. It accounts for 0.09 % of prostatic malignancies [1]. It commonly presents in the seventh decade with Lower Urinary Tract Symptoms (LUTS). Diffuse large B cell lymphoma is the common pathological variant [2]. Chemotherapy and radiotherapy are the common modalities of treatment and the overall prognosis is poor [2]. We present a 26 year old HIV infected patient - on anti-retroviral therapy who presented with acute renal failure and grossly enlarged prostate. Prostate biopsy with immuno-histochemistry confirmed the diagnosis of Peripheral T-cell lymphoma. He was treated with Adriamycin based chemotherapy and radiotherapy. We report this case in view of the rarity the tumor, younger age at presentation than that is available in literature and the pathological variant not reported in primary prostatic lymphoma.

A Review on the Clinical Utility of PSA in Cancer Prostate.

Prostate cancer has come to share the oncological centrestage among male cancers. The availability of Serum Prostate Specific Antigen, PSA, as a marker has encouraged it's use to diagnose both cancer and cancer recurrence. Some clarity is required about its precise role in clinical practice. The available literature on Prostate Specific Antigen was reviewed; Articles were reviewed for content, applicability to the problem at hand, availability of data about sensitivity and specificity of values, refinements in measurements and finally for impact of screening programmes using these values on survival and quality of life. The data in the literature was critically re-evaluated and analysed to draw reasonable conclusions. Serum PSA measurements show variable reliability when it comes to diagnosis of Prostate cancer, given the dynamics of PSA physiology. Surrogate measures like PSA density, PSA velocity, free-to-complexed PSA ratio, percentage Pro-PSA, etc., have been used to improve the predictive utility of this assay for Prostate cancer. The ability of PSA to detect those cancers that will cost life, and thereby permit early curative treatment, is as yet unclear. It's most definitive role appears to be in diagnosing recurrences after adequate surgical treatment, and in evaluating response to treatment.

Role of dysautonomic symptoms in distinguishing Parkinson's disease (PD) from multiple system atrophy (MSA-P) within a year of developing motor symptoms.

OBJECTIVE: Can dysautonomic symptoms occurring within a year of developing motor symptoms distinguish Multiple system atrophy-Parkinsonian (MSA-P) from Parkinson's disease (PD)? PATIENTS AND METHODS: Seventy-two Parkinsonian patients diagnosed as probable PD or MSA-P. RESULTS: PD (n = 58, 80.6%) and MSA (n = 14, 19.4%) patients were of similar age and had motor symptoms for similar duration. PD first presents with motor symptoms (68.3%) while MSA-P presents with dysautonomia (85.7%). Urinary incontinence was reported by MSA-P (64%) at their first visit and was absent in most PD (98%) patients. CONCLUSIONS: Urinary incontinence and orthostatic symptoms occurring in a parkinsonian patient within one-year history of motor symptoms suggests a diagnosis of MSA-P with high accuracy and their absence suggests PD.

Urogenital symptoms in Parkinson's disease and multiple system atrophy-Parkinsonism: at onset and later.

METHODS: One hundred and eighty-one parkinsonian patients were evaluated to determine if urogenital symptoms at presentation to the Neurology clinic can differentiate them as PD or MSA-P. An autonomic questionnaire was used to document urinary and genital symptoms. RESULTS: Mean age at presentation and disease duration in PD and MSA-P were similar. Urinary symptoms occurred twice as frequently in MSA-P than in PD. Storage symptoms (frequency, urgency, urge incontinence, nocturia) were common in both Parkinsonian disorders. Male MSA-P reported genital symptoms (erectile and ejaculatory failure) three times more frequently than in PD. CONCLUSIONS: Urogenital symptoms occurred in MSA-P when they had mild motor few symptoms unlike in PD where they occur when motor symptoms were severe. Urogenital dysfunction occurred early and was present in all MSA-P patients within two years. Presence of urogenital symptoms in early stages of Parkinsonism strongly favors MSA-P rather than PD. Absence of urogenital symptoms in advanced Parkinsonism makes MSA-P unlikely.