Secondary chronic lymphocytic leukemia (CLL) in the prostate
DOI: 10.22591/magyurol.2023.1.schnemannb.34
Authors:
Schnémann Bence dr.1, Laczkó István dr.1, Hargitai Zoltán dr.2, Szász Róbert dr.3, Vályi Éva dr.4, Osváth Péter dr.1, Szűcs Miklós dr.1
1Debreceni Egyetem Klinikai Központ, Kenézy Gyula Campus, Urológiai és Andrológiai Osztály, Debrecen (osztályvezető: Szűcs Miklós dr.)
2Debreceni Egyetem Klinikai Központ, Kenézy Gyula Campus, Pathológia Osztály, Debrecen (osztályvezető: Kovács Ilona dr.)
3Debreceni Egyetem Klinikai Központ, Nagyerdei Campus, Hematológia Tanszék, Debrecen (tanszékvezető: Illés Árpád dr.)
4Debreceni Egyetem Klinikai Központ, Kenézy Gyula Campus, Radiológia Osztály, Debrecen (osztályvezető: Bágyi Péter dr.)
Summary
Introduction: The authors present a case of a lymphoma disease affecting the prostate, which is considered a rare entity.
Case report: A 78-year-old patient with a history of thalassemia and B-cell chronic lymphocytic leukaemia had had a transurethral resection of the prostate for lower urinary tract obstruction. Pathological report showed chronic prostatitis. During follow-up his post operative PSA level elevated to 14.55 ng/ml after 15 months of operation. On rectal examination he had benign enlargement. Pelvic multi parametric MRI (1.5 Tesla) was performed with a result of suspicion of malignancy in the peripheral zones on both sides. The enlarged lymph nodes on MRI suggested myeloproliferative involvement. Transrectal ultrasound guided prostate biopsy was performed. Histological and immunohistochemical examination confirmed indolent B-cell lymphoma in the prostate. Regarding the progression in the blood count, clinical signs and imaging, the patient was switched to active haematological treatment until complete remission was achieved. After treatment his PSA level was checked every year with a result of 7.4 ng/ml, 7.54 ng/m and 7.05 accordingly. The patient is under regular urological and haematological follow-up since the biopsy.
Discussion: Our case report draws attention to a rare disease. Even a simple and common prostate biopsy can result in difficulties in diagnosis. All aspects of possible diagnosis must be considered with special attention to patient history. In such cases, after the diagnosis is established, consulting other medical specialties is necessary as soon as possible for further adequate treatment.