Leukaemic infiltration of the prostate

Abstract

Leukaemic infiltration of the prostate is not a common occurrence. Two cases, both from country hospitals in Victoria (Bendigo and Hamilton) are presented in this communique. The first one, 75-yr-old, initially presented in August 1977 with splenomegaly and generalized lymphadenopathy. Diagnosis of chronic lymphatic leukaemia was confirmed from marrow examination. He soon developed urinary symptoms of prostatism, which did not improve on chemotherapy for leukaemia. Transurethral prostatic resection was undertaken when histological examination showed neoplastic infiltration of the prostatic stroma by well differentiated lymphocytes. The second patient, 67 yr old, in very good health except for intermittent urinary retention symptoms was admitted in January 1978 in Bendigo for prostatectomy. Chronic lymphatic leukaemia was discovered on routine blood examination before the operation and subsequently confirmed by marrow studies. Chemotherapy was initiated and a few weeks later, transurethral prostatectomy was carried out. Histology revealed massive neoplastic lymphocytic infiltration of the stroma. Review of the literature on the subject revealed sporadic reporting of the individual cases. Precise incidence is unknown. Cases have been diagnosed from postmortem material, surgical specimens and needle biopsies. Attention is drawn to the lack of careful and critical examination of the prostate during autopsy of leukaemic patients. Needle biopsy of the prostate may yield a false negative result in the event of focal leukaemic infiltration of the prostatic stroma. A contributory role of the infiltration towards obstructive urinary symptoms is debatable, although, in one case of acute myeloid leukaemia, local radiotherapy completely relieved the symptoms. Urinary retention has been reported more often in association with granulocytic leukaemia than lymphatic leukaemia. Prostatectomy in chronic lymphatic leukaemic patients with prostate involvement seems to be without any post-operative complication, treatment of leukaemia itself being indicated only on medical grounds.