Primary Non-Hodgkin Lymphoma of the Urethra
Keywords:
Non-Hodgkin lymphoma, Extranodal, UrethraAbstract
Abstract: A 73-year old lady presented with a painless mass originating from the introitus, without fever or weight loss. The tumor grew over a few months, obstructing urethra. She also had diabetes mellitus, well controlled with glibenclamide. Physical examination revealed a fungating mass, size 8x4 cm originating from the urethral meatus, no other node, no hepatosplenomegaly. The pathological diagnosis was diffuse large B-cell non-Hodgkin’s lymphoma (NHL), stage IEA. The HIV antibody was negative and serum LDH was normal. Primary NHL of the urethra among patients without HIV infection is rare and has not been reported in Thai patients. The patient had partially surgical resection, followed by local irradiation and 6 cycles of CHOP regimen respectively. She tolerated treatment well, was alive and free from the disease at 2.5-year follow-up visit.
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References
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15. Pongpruttipan T, Pongtongcharoen P, Sukpanichnant S. Mature T-Cell and NK-Cell Lymphomas in Thailand: An Analysis of 71 Cases. J Med Assoc Thai 2011;94:743-8.
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17. Chitsobhak T, Atichartakarn V, Jootar S, et al. Central nervous system involvement of Non-Hodgkin’s Lymphomas. Thai J Hematol Transf Med 2004;14:251-61.
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19. Makruasi N, Niparuck P, Sungkanuparph S, et al. Non-Hodgkin’s Lymphoma (NHL) in HIV infected patients in Thailand. J Infect Dis Antimicrob Agents 2011;28:5-14.
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22. Ferry JA. Extranodal Lymphoma. Arch Pathol Lab Med 2008; 132:565–78.
23. Nabholtz JM, Friedman S, Tremeaux JC, et al. Non-Hodgkin’s lymphoma of the urethra: a rare extranodal entity. Gynecol Oncol 1989;35:110-1.
24. Shimizu Y, Ogawa O, Terachi T, Okada Y, Yoshida O. A case of primary urethral lymphoma presenting as a huge mass surrounding the female urethra. Hinyokika Kiyo 1997;43:229-32.
25. Rajan N, Allman D, Scaglia B, et al. Non-Hodgkin’s lymphoma of the male urethra. J Urol 1995;153:1916-7.
26. Hatcher PA, Wilson DD. Primary lymphoma of the male urethra. Urol 1997;49:142-4.
27. Hartge P, Devesa SS. Quantification of the impact of known risk factors on time trends in NHL incidence. Cancer Res 1992; 52(suppl 19):5566s-9s.
28. Parker A, Bowles K, Bradley A, et al. Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients – BCSH and BTS Guidelines. Br J Haematol 2010;149:675-92.
29. Ekström Smedby K, Vajdic CM, Falster M, et al. Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium. Blood 2008;111: 4029-38.
30. Mitri, J, Castillo J, Pittas AG. Diabetes and risk of Non-Hodgkin’s Lymphoma. A meta-analysis of observational studies. Diabetes Care 2008;31:2391-7.
31. Chao C, Page JH. Type 2 diabetes mellitus and risk of Non-Hodgkin Lymphoma: A systematic review and meta-analysis. Am J Epidemiol 2008;168:471-80.
32. Castillo JJ, Mull N, Reagan JL, Mitri J. Increased incidence of non-Hodgkin’s lymphoma, leukemia, myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies. Blood 2012;119:4845-50.
33. Khan AE, Gallo V, Linseisen J, et al. Diabetes and the risk of non-Hodgkin’s lymphoma and multiple myeloma in the European Prospective Investigation into Cancer and Nutrition. Haematologica 2008;93:842-50.
34. Inuzuka S, Koga S, Imanishi D, Matsuo T, Kanetake H. Primary malignant lymphoma of the female urethra. Anticancer Res 2003;23:2925-7.
35. Kahn DG, Rothman PJ, Weisman JD. Urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome. Arch Pathol Lab Med 1991; 115: 1169-70.
36. Lopez AE, Latiff GA, Ciancio G, Antun R. Lymphoma of urethra in a patient with acquired immune deficiency syndrome. Urol 1993;42:596-8.
37. Simpson RH, Bridger JE, Anthony PP, James KA, Jury I. Malignant lymphoma of the lower urinary tract. A clinicopathological study with review of the literature. Br J Urol 1990;65:254-60.
38. A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med 1993;329:987-94.
2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-60.
3. Sheth S, Ali S, Fishman E. Imaging of renal lymphoma: patterns of disease with pathologic correlation. RadioGraphics 2006;26:1151-68.
4. Hofmockel G, Dämmrich J, Manzanilla GH, Wirth MP, Frohmüller HG. Primary non-Hodgkin’s lymphoma of the male urethra. A case report and review of the literature. Urol Int 1995;55:177-80.
5. Melicow MM, Lattes R, Pierre-Louis C. Lymphoma of the female urethra masquerading as a caruncle. J Urol 1972;108:748-9.
6. Chaitin BA, Manning JT, Ordóñez NG. Hematologic neoplasms with initial manifestations in lower urinary tract. Urology 1984; 23:35-42.
7. Touhami H, Brahimi S, Kubisz P, Cronberg S. Non-Hodgkin’s lymphoma of the female urethra. J Urol 1987;137:991-2.
8. Rajan N, Allman D, Scaglia B, et al. Non-Hodgkin’s lymphoma of the female urethra. J Urol 1987;153:991-2.
9. Muraoka K, Hunahashi M, Nagashima M, Osada Y, Kitami K. A patient with a primary malignant lymphoma surrounding the female urethra. Hinyokika Kiyo 2009;55:357-60.
10. Intragumtornchai T, Wannakrairoj P, Chaimongkol B, et al. Non-Hodgkin’s lymphomas in Thailand. A retrospective pathologic and clinical analysis of 1,391 cases. Cancer 1996;78:1813-9.
11. Sukpanichnant S, Sonakul D, Piankijagum A, et al. Malignant lymphoma in Thailand. Changes in the frequency of malignant lymphoma determined from a histopathologic and immuno-phenotypic analysis of 425 cases at Siriraj Hospital. Cancer 1998;83:1197–204.
12. Sukpanichnant S, Udomsakdi-Auewarakul C, Ruchutrakool T, Leelakusolvong S, Boonpongmanee S, Chinswangwatanakul V. Gastrointestinal lymphoma in Thailand: A clinicopathologic analysis of 120 cases at Siriraj Hospital according to WHO Classification. Southeast Asian J Trop Medicine 2004;35:966-76.
13. Assanasen T, Wannakrairot P, Keelawat S, Pramprayoon N, Chaipipat M. Extranodal malignant lymphoma of the upperaerodigestive tract in King Chulalongkorn Memorial Hospital according to WHO classification. J Med Assoc Thai 2004;87(Suppl 2):S249-54.
14. Intragumtornchai T, Rojnuckarin P, Sutcharitchan P, Wannakrairot P. Mantle cell lymphoma in Thai patients. J Med Assoc Thai 2004;87:1071-5.
15. Pongpruttipan T, Pongtongcharoen P, Sukpanichnant S. Mature T-Cell and NK-Cell Lymphomas in Thailand: An Analysis of 71 Cases. J Med Assoc Thai 2011;94:743-8.
16. Assanasen T, Wannakrairot P, Keelawat S, Ruangvejvorachai P, Pramprayoon N. Extranodal malignant lymphoma of the upper aerodigestive tract: Prevalence of Epstein-Barr Virus (EBV) infection in King Chulalongkorn Memorial Hospital. J Med Assoc Thai 2005;88(Suppl 4):S266-73.
17. Chitsobhak T, Atichartakarn V, Jootar S, et al. Central nervous system involvement of Non-Hodgkin’s Lymphomas. Thai J Hematol Transf Med 2004;14:251-61.
18. Klubcharoen S. Malignant lymphoma: A study of 187 cases in Khon Kaen Regional Hospital. Khon Kaen Med J 1993;17:13-20.
19. Makruasi N, Niparuck P, Sungkanuparph S, et al. Non-Hodgkin’s Lymphoma (NHL) in HIV infected patients in Thailand. J Infect Dis Antimicrob Agents 2011;28:5-14.
20. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the Committee on Hodgkin’s Disease Staging Classification. Cancer Res 1971;31:1860–1.
21. Devesa SS, Fears T. Non-Hodgkin’s lymphoma time trends: United States and International Data. Cancer Res 1992;52(suppl19): 5432s-40s.
22. Ferry JA. Extranodal Lymphoma. Arch Pathol Lab Med 2008; 132:565–78.
23. Nabholtz JM, Friedman S, Tremeaux JC, et al. Non-Hodgkin’s lymphoma of the urethra: a rare extranodal entity. Gynecol Oncol 1989;35:110-1.
24. Shimizu Y, Ogawa O, Terachi T, Okada Y, Yoshida O. A case of primary urethral lymphoma presenting as a huge mass surrounding the female urethra. Hinyokika Kiyo 1997;43:229-32.
25. Rajan N, Allman D, Scaglia B, et al. Non-Hodgkin’s lymphoma of the male urethra. J Urol 1995;153:1916-7.
26. Hatcher PA, Wilson DD. Primary lymphoma of the male urethra. Urol 1997;49:142-4.
27. Hartge P, Devesa SS. Quantification of the impact of known risk factors on time trends in NHL incidence. Cancer Res 1992; 52(suppl 19):5566s-9s.
28. Parker A, Bowles K, Bradley A, et al. Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients – BCSH and BTS Guidelines. Br J Haematol 2010;149:675-92.
29. Ekström Smedby K, Vajdic CM, Falster M, et al. Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium. Blood 2008;111: 4029-38.
30. Mitri, J, Castillo J, Pittas AG. Diabetes and risk of Non-Hodgkin’s Lymphoma. A meta-analysis of observational studies. Diabetes Care 2008;31:2391-7.
31. Chao C, Page JH. Type 2 diabetes mellitus and risk of Non-Hodgkin Lymphoma: A systematic review and meta-analysis. Am J Epidemiol 2008;168:471-80.
32. Castillo JJ, Mull N, Reagan JL, Mitri J. Increased incidence of non-Hodgkin’s lymphoma, leukemia, myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies. Blood 2012;119:4845-50.
33. Khan AE, Gallo V, Linseisen J, et al. Diabetes and the risk of non-Hodgkin’s lymphoma and multiple myeloma in the European Prospective Investigation into Cancer and Nutrition. Haematologica 2008;93:842-50.
34. Inuzuka S, Koga S, Imanishi D, Matsuo T, Kanetake H. Primary malignant lymphoma of the female urethra. Anticancer Res 2003;23:2925-7.
35. Kahn DG, Rothman PJ, Weisman JD. Urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome. Arch Pathol Lab Med 1991; 115: 1169-70.
36. Lopez AE, Latiff GA, Ciancio G, Antun R. Lymphoma of urethra in a patient with acquired immune deficiency syndrome. Urol 1993;42:596-8.
37. Simpson RH, Bridger JE, Anthony PP, James KA, Jury I. Malignant lymphoma of the lower urinary tract. A clinicopathological study with review of the literature. Br J Urol 1990;65:254-60.
38. A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med 1993;329:987-94.
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Published
2019-06-27
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รายงานผู้ป่วย (Case report)
