Abstract
BackgroundPrimary lymphoma of the prostate is an exceedingly rare disease, with diffuse large B-cell lymphoma being the most common known subtype in a small number of reported cases. Due to its low prevalence, there has been a chronic lack of targeted diagnostic guidelines and treatment procedures.Case presentationIn this article, we report a case of primary diffuse large B-cell lymphoma of the prostate in a 70-year-old Asian man who presented with symptoms of urinary tract obstruction. Histological and immunocytochemical studies of transurethral biopsy of the prostate showed diffuse large B-cell lymphoma. The patient was managed by a combination of eight courses of chemotherapy with a regimen including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone and radiotherapy. Post-chemotherapy computed tomography scans showed complete remission. He remained disease free, until now, 15 months after the end of therapy. We also reviewed and analyzed relevant literature to illustrate the diagnosis, treatment, and prognosis of this disease.ConclusionDiffuse large B-cell non-Hodgkin’s lymphoma originating in the prostate is a rare and highly aggressive disease that lacks specificity in its clinical presentation and is easily misdiagnosed. This disease should be considered clinically in patients with significant prostate enlargement and insignificant prostate-specific antigen elevation. The diagnosis can be clarified with a prostate puncture biopsy. Chemotherapy is the main treatment for patients and may be supplemented with surgical treatment and radiotherapy.
Highlights
Primary lymphoma of the prostate is an exceedingly rare disease, with diffuse large B-cell lymphoma being the most common known subtype in a small number of reported cases
The diagnosis can be clarified with a prostate puncture biopsy
Chemotherapy is the main treatment for patients and may be supplemented with surgical treatment and radiotherapy
Summary
Primary diffuse large B-cell lymphoma of the prostate is a rare and highly aggressive disease. Due to its nonspecific symptoms, it is easy to be misdiagnosed as other prostate conditions before a surgical biopsy. This reminds us that the possibility of this disease should always be considered in the differential diagnosis. The prognosis of primary lymphoma of the prostate is generally considered to be poor, the disease can be controlled effectively in most patients with the application of chemotherapy and local radiotherapy. We will be able to provide a more rational individualized treatment plan for these patients and achieve better therapeutic outcomes
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