Primary Prostatic Lymphoma Presenting with Features of Prostatism Developed Central Nervous System (CNS) Symptoms During Chemotherapy: A Case Report

Jiaxin Wang,Yuhong Lu,Jiaxiong Tan,Yu Ding

doi:10.11648/j.jctr.20200803.12

Abstract

Primary lymphoma of prostate is rare representing approximately 0.1% of all non-Hogdk in lymphomas. This type of lymphoma is more common in men with an average age of 60 years old. Dysuria is the most common symptom of prostatic lymphoma, which can lead to misdiagnosis of benign prostatic hyperplasia and adenocarcinoma easily. Besides, PSA was widely considered in the normal range in most patients with prostatic lymphoma, only a few patients showed elevated. We report a case of a 72-year-old primary prostatic diffuse large B-cell lymphoma patient with a significant increasing of PSA, developed Central Nervous System (CNS) symptoms after completing a cycle of R-CHOP therapy. Unfortunately, the patients received R-CHP in combination with high dose immunoglobulin, after a brief relief of CNS symptoms, the similar CNS symptoms returning again later. Involvement of CNS symptoms during therapy represents a serious complication of aggressive lymphoma, which is rare occurring nearly 5% of non-Hodgkin lymphoma and is considered as a high-risk model In conclusions, primary prostatic lymphoma with an increasing of prostatic-specific antigen is a rare case that is easily misdiagnosed. R-CHOP is till the recommended regimen, but other safe and effective alternatives are urgently needed when obvious CNS symptoms occurred during treatment.

Highlights

Primary prostatic lymphoma is rare representing approximately 0.1% of all non-Hogdkin lymphomas which occur in men aged 60 years in average [1, 2] Dysuria is the most common symptom of prostatic lymphoma, which can lead to misdiagnosis of benign prostatic hyperplasia and adenocarcinoma
[4] We report a case of a 72-year-old primary prostatic diffuse large B-cell lymphoma patient with a significant increasing of PSA, developed Central Nervous System (CNS) symptoms after completing a cycle of R-CHOP therapy
Dysuria is the most common symptom of prostatic lymphoma, which leading to difficulty in distinguishing clinically from benign prostatic hyperplasia and adenocarcinoma of prostate

Summary

Introduction

Primary prostatic lymphoma is rare representing approximately 0.1% of all non-Hogdkin lymphomas which occur in men aged 60 years in average [1, 2] Dysuria is the most common symptom of prostatic lymphoma, which can lead to misdiagnosis of benign prostatic hyperplasia and adenocarcinoma . PSA was widely considered in the normal range in most patients with prostatic lymphoma, only a few patients showed elevated [1, 3]. There is no consensus on the treatment but the recommended treatments included radiotherapy, chemotherapy and prostatectomy referring to the case report [4] We report a case of a 72-year-old primary prostatic diffuse large B-cell lymphoma patient with a significant increasing of PSA, developed CNS symptoms after completing a cycle of R-CHOP therapy. We have discussed the clinical features, diagnosis and treatment of this rare patient in the light of the literature

Case Report

Findings

Discussion

Conclusion