We report the case of an 83-year-old hypertensive male who came to the emergency department of our hospital for oligoanuria and deterioration of the general condition of 48 hours of evolution.
She had not previously reported any voiding symptoms.
Bladder catheterization was performed without significant diuresis.
Blood analysis showed an increase in creatinine of 10 mg/dl and potassium of around 6.9.
Abdominal ultrasound was performed determining parietal thickening at the trigone level, and bilateral obstructive uropathy with bilateral grade III/IV renal dilatation; therefore, a double cystoscopy was performed and an attempt to place a double J stent was made.
In the bladder examination, a large bladder mass is observed, which rejects ureteral orifices laterally, being impossible ureteral catheterization, so a bilateral percutaneous nephrostomy is performed.
Once the diagnosis was established and the patient stabilized, a transurethral resection of the bladder mass was performed with an uneventful postoperative course.
Pathological Anatomy was reported as diffuse large cell non-Hodgkin B lymphoma, with markers CD45+, CD20+, CD79a+, CD10+, CD3-, AL4530AE, B
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After the results obtained, an extension study was carried out with thoracic, abdominal and pelvic CT, determining only diffuse thickening of the bladder wall, without involvement at another level.
This absence of disease in another location led to the diagnosis of primary bladder lymphoma.
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After the confirmation diagnosis was made, the patient was started on chemotherapy type CHOP (acquired fever), doxorubicin, prednisone and prednisone), and obstructive uropathy disappeared as the most relevant finding.
The patient is currently disease-free after 14 months of follow-up.
