AI Article Synopsis

  • Primary bladder lymphoma is usually seen as a favorable condition due to low-grade lymphomas mostly found in the bladder, but cases with extravesical extension, especially diffuse large B-cell lymphoma (DLBCL), show varied clinical outcomes.
  • A detailed analysis of 47 patients, including one case of a 77-year-old man misdiagnosed with a severe urinary infection, revealed the complexities in diagnosing bladder lymphomas and highlighted that DLBCL is more common in extravesical cases.
  • The study emphasizes the need for careful diagnosis and tailored treatment strategies for patients with primary bladder lymphoma and extravesical extension due to their distinct clinical challenges and poor prognostic implications.

Article Abstract

Primary bladder lymphoma is generally regarded as having a favorable prognosis due to the predominance of low-grade lymphomas confined to the bladder. However, our investigation reveals that cases with extravesical extension, predominantly involving diffuse large B-cell lymphoma (DLBCL), exhibit a distinct clinical course with varied prognostic outcomes. In this report, we present and analyzed the clinical features and outcomes of 47 patients with primary bladder lymphoma with extravesical extension, including the case that we experienced. An 77-year-old man who experienced fever, anorexia, and general malaise was referred to our hospital. Initial laboratory tests indicated severe renal failure, pyuria, and bacteremia, accompanied by diffuse thickening of the bladder walls and increased attenuation in the surrounding adipose tissues. Initially misdiagnosed with a severe urinary tract infection leading to sepsis, the patient was treated with antibiotics and hemodialysis. Upon readmission due to abdominal pressure, imaging identified an intra-abdominal mass connected to the bladder wall. A bladder biopsy was performed, resulting in the diagnosis of primary bladder DLBCL with perivesical extension, classified as germinal center B-cell type. Taking inspiration from this case, the review of 46 patients was implemented. As a result, we resolved that primary bladder lymphoma often includes indolent types like Mucosa-associated lymphoid tissue lymphoma, but cases with extravesical expansion are predominantly DLBCL. This case emphasizes the diagnostic complexities of distinguishing primary bladder lymphoma from urinary tract infections and underscores the prognostic implications of extravesical extension. Our comprehensive review of the literature on primary bladder lymphomas with extravesical involvement highlights the clinical characteristics, therapeutic challenges, and need for heightened diagnostic vigilance and tailored treatment strategies for this subset of patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11313225PMC
http://dx.doi.org/10.3390/jcm13154340DOI Listing

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