This is a patient of years, who had a personal history of interest presented with resolved pulmonary tuberculosis; angina pectoris with chest discomfort pre-obstructive prophylaxis, childhood prophylitis in 1997, hemorrhage and recurrent apnea-hypopnea syndrome, treatment with CPAP, treated by a
Recently, a celiac lymphadenopathy pending filiation was diagnosed as a result of an abdominal ultrasound.
As a family history, his father had died of colon cancer.
He came to consultation for review, presenting a prostatic symptoms with severe impairment of his quality of life (IPSS:22; L:4), a PSA of 1.6 ng/ml, a firboelastic prostate non-palpable.
The patient delayed it because a laparoscopic cholecystectomy and a lymph node biopsy were performed to filiate the celiac adenopathy, with a diagnosis of reactive lymphoid hyperplasia.
Subsequently, a prostate TUR was performed, which was uneventful.
The histological study showed areas of normal prostatic tissue, with normal glands and stroma, muscle and tissue, as well as coagulation disorders by TURP.
Other areas with higher glandular density and lower stromal density, diagnosis of Nodular Hypertrophy of Prostate.
Other areas were seen in which prostatic glands were visualized, absence of normal stroma, very dense cell proliferation in the stroma, which with greater increase allowed the visualization of round and small cells.
This led to a differential diagnosis between anaplastic small cell lymphoma, ca., and a neuroendocrine melanoma.
Immunochemistry techniques were performed.
The following markers were positive: CD 20+;CD 10+, BCL2+, BCL6+, typical of B lymphocytes, follicular origin and non-Hodgkin lymphomas. A molecular study of follicular observe lymphoma was performed after 14
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With the anatomopathological diagnosis of diffuse small-medium-cell lymphoma type b (CD 20+;CD 10+, BCL2+, BCL6+) and benign prostatic hyperplasia.
The study was completed by bone marrow biopsy, without evidence of tumor recurrence.
CT scan and PET.
CT scan showed a cervical lymphadenopathy, left inguinal lymph node metastasis, right lower paratracheal lymphadenopathy, signs, cholecystectomy, PET scan showed uptake of mediastinal lymphadenopathy (paramandibular).
A karyotype with 46XY result was performed.
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With the diagnosis of follicular non-Hodgkin’ s lymphoma Stage IIIEA of prostate IPI:1 FLI:1;;1; polychemote, treatment with antimycotic agents was proposed as a first line therapy with anti-MDP).
For six cycles.
Subsequently, the patient underwent revisions without evidence of recurrence, with good response to treatment.
Control imaging studies were performed using CT and PET, observing the disappearance of lymph nodes.
After 24 months follow-up the patient remains asymptomatic without evidence of recurrence.
