PRIMARY MALIGNANT LYMPHOMA OF THE BLADDER1

Abstract

SUMMARY 1. Eight cases of malignant lymphoma of the bladder are presented, and their clinical and pathological features discussed with reference to twenty-three cases from the literature up to 31st December 1959. 2. Malignant lymphoma of the bladder occurs more frequently in females than in males. The majority of the patients are over the age of 40 years. 3. The commonest presenting symptom is periodic hematuria. It is very often associated with dysuria and frequency of micturition. 4. Back-pressure changes in renal pelves and ureters are characteristically absent or minimal. 5. Cystoscopic appearances are very typical. It forms a smooth or nodular (occasionally convoluted), rounded, pink, and solid tumour that is essentially submucous. The mucosa over it is usually intact but occasionally central ulceration may be seen. It infiltrates relatively little compared to its size. 6. Histologically, in the less extensive cases, the tumour is confined to the deeper part of the lamina propria. Later on, the superficial part of the lamina propria and the muscle are infiltrated. Muscle is infiltrated in most cases but perivesical invasion is unusual. The cells consist mainly of lymphocytes, lymphoblasts, and reticulum cells. Histological subdivision of the tumour is often difficult and at times impossible. Hence it is best to consider them under a single non-specific title of malignant lymphoma. 7. Radiotherapy appears to be the treatment of choice, though it is also possible to get good results with surgery. 8. Prognosis is favourable because the tumours tend to remain localised for a considerable time. So far, none of these eight cases has shown any sign of dissemination. Their survivals (at the time of the last examination) have ranged from four months to ten years.