Abstract
We present a case of primary malignant lymphoma of the prostate in a 77-year-old Japanese man. Immunohistochemical examinations revealed the presence of a non-GCB subtype of DLBCL (CD10 (-), Bcl-6 (-), MUM1 (+)), and genetic analysis disclosed a lack of typical codon 206 or 265 missense mutation in MYD88, suggesting that the case was of type3 (non-GCB andnon-ABC), a subtype of DLBCL. Three courses of chemotherapy (rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)) were effective, and the patient has been free of the disease with no local or systemic recurrence for three years. Although the significance of silent mutation at hot spot of the highly oncogenic MYD88 gene in this case is unclear, a minute increase in translational efficiency by silent mutation may have contributed to the activation of MYD88.
Highlights
We describe a case of prostatic diffuse large B-cell lymphoma (DLBCL) carrying silent MYD88 mutation in a 77-year-old man, which was successfully managed with rituximab-based chemotherapy
Fewer than 150 cases have been described in the literature, among which DLBCL is the most common type, followed by small lymphocytic lymphoma, follicular lymphoma, Burkitt’s lymphoma, MALT lymphoma, and mantle cell lymphoma [4]
Since the first report of highly oncogenic MYD88 p.L265P mutation in the activated B-cell like (ABC) subtype of DLBCL [3], L265P mutation has been detected in primary central nervous system lymphoma, in primary cutaneous leg type DLBCL [5] and in Waldenstrom’s macroglobulinemia [6], indicating that MYD88 is one of the target genes of certain subsets of B-cell malignancies at an early stage of oncogenesis
Summary
Primary lymphoma of the prostate is extremely rare, representing approximately 0.2% to 0.8% of extra nodal lymphoma and less than 0.1% of all prostate neoplasms [1]. We describe a case of prostatic diffuse large B-cell lymphoma (DLBCL) carrying silent MYD88 mutation in a 77-year-old man, which was successfully managed with rituximab-based chemotherapy. How to cite this paper: Yoshida, K., Kitazawa, R., Komoda, M., Ito, C., Haraguchi, R. and Kitazawa, S. (2014) Primary Malignant Lymphoma of Prostate with Silent MYD88 Mutation. Case Reports in Clinical Medicine, 3, 125-128.
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