A 70-year-old man with a history of endoscopic resection of the prostate ten years ago proved a BPH.
Complained of left exophthalmos in July 1995, he underwent surgical removal of a tumor that affected the left retro-ocular fat followed by local irradiation at that level; diagnosed as a primary malignancy grade non-follicular lymphoma.
In February 1998 the patient presented lymph node recurrence with non-bullous affectation at supraclavicular level and mediastinum with histology of low grade B lymphoma that followed an indolent clinical course without requiring treatment.
In March 2000, a control CT scan diagnosed a 1.5 cm nodular appearance of the left bladder wall.
The patient was operated on by endoscopic resection of the solid bladder tumor. The lamina propria was demonstrated respecting the lining urothelium.
Histology showed low-grade non-Hodgkin's lymphoma with B cells and a nodular pattern of probable follicular center (in immunohistochemical study was observed positivity of the cellular zones b, with strong follicle origin and CD10 antibodies).
T cell markers were negative.
The definitive diagnosis was follicular Gr non-Hodgkin's lymphoma.
I (WHO classification).
Subsequently he continued on treatment with Clorambucil and Prednisone until April 2001.
In 2003, a CT scan performed in routine pelvic locations included in December 2003, a 4 cm diameter hypoechogenic nodular lesion with homogeneous structure and solid appearance was detected in the right kidney.
Tumorectomy of a well-encapsulated neoplasm was performed with biopsy of the adjacent perirenal fat.
The pathology was similar to that already obtained in the bladder and confirmed that it is a low-grade non-Hodgkin lymphoid neoplasia of low grade B, with involvement of the renal cortex center and malignant pattern consisting of perichemical fat cells.
1.
In both bladder and kidney proliferation was lymphoid habit and showed a follicular pattern with neoplasic follicles attached to each other, poorly defined, without mantle zone and heterogeneous diameters
The lymphoid cells that constituted them were of the centrocyte type, of small size, with irregular nucleus and scarce cytoplasm and were intermingled with a scarce population of centripetal cells, larger nuclei
No diffuse or high-grade areas were observed.
