PDF(Pubmed)
Abstract：
Background: Primary bladder lymphoma is generally regarded as having a favorable prognosis due to the predominance of low-grade lymphomas confined to the bladder. However, our investigation reveals that cases with extravesical extension, predominantly involving diffuse large B-cell lymphoma (DLBCL), exhibit a distinct clinical course with varied prognostic outcomes. Methods: In this report, we present and analyzed the clinical features and outcomes of 47 patients with primary bladder lymphoma with extravesical extension, including the case that we experienced. Results: An 77-year-old man who experienced fever, anorexia, and general malaise was referred to our hospital. Initial laboratory tests indicated severe renal failure, pyuria, and Escherichia coli bacteremia, accompanied by diffuse thickening of the bladder walls and increased attenuation in the surrounding adipose tissues. Initially misdiagnosed with a severe urinary tract infection leading to sepsis, the patient was treated with antibiotics and hemodialysis. Upon readmission due to abdominal pressure, imaging identified an intra-abdominal mass connected to the bladder wall. A bladder biopsy was performed, resulting in the diagnosis of primary bladder DLBCL with perivesical extension, classified as germinal center B-cell type. Taking inspiration from this case, the review of 46 patients was implemented. As a result, we resolved that primary bladder lymphoma often includes indolent types like Mucosa-associated lymphoid tissue lymphoma, but cases with extravesical expansion are predominantly DLBCL. Conclusions: This case emphasizes the diagnostic complexities of distinguishing primary bladder lymphoma from urinary tract infections and underscores the prognostic implications of extravesical extension. Our comprehensive review of the literature on primary bladder lymphomas with extravesical involvement highlights the clinical characteristics, therapeutic challenges, and need for heightened diagnostic vigilance and tailored treatment strategies for this subset of patients.
摘要：
背景：原发性膀胱淋巴瘤通常被认为具有良好的预后，因为局限于膀胱的低度淋巴瘤占主导地位。然而,我们的调查显示，案例具有夸张的延伸，主要累及弥漫性大B细胞淋巴瘤（DLBCL），表现出不同的临床过程与不同的预后结果。方法：在本报告中，我们介绍并分析了47例原发性膀胱淋巴瘤伴膀胱外延伸患者的临床特征和预后，包括我们经历过的案子.结果：一名77岁的男子发烧，厌食症,全身不适被转诊到我们医院。最初的实验室检查显示严重的肾衰竭,脓尿,和大肠杆菌菌血症，伴有膀胱壁的弥漫性增厚和周围脂肪组织的衰减增加。最初误诊为严重的尿路感染导致败血症，患者接受抗生素和血液透析治疗.由于腹压再次入院时，影像学检查确定了与膀胱壁相连的腹内肿块。进行了膀胱活检，导致诊断原发性膀胱DLBCL伴膀胱周围扩张，分类为生发中心B细胞型。从这个案例中获得灵感，对46例患者进行了审查.因此,我们解决了原发性膀胱淋巴瘤通常包括惰性类型，如粘膜相关淋巴组织淋巴瘤，但过度扩张的病例主要是DLBCL。结论：该病例强调了将原发性膀胱淋巴瘤与尿路感染区分开来的诊断复杂性，并强调了膀胱外扩展的预后意义。我们对原发性膀胱淋巴瘤伴膀胱外受累的文献进行了全面回顾，突出了其临床特征，治疗挑战，并且需要对这部分患者提高诊断警惕性和量身定制的治疗策略.
