A 28-year-old male patient was admitted for dysuria and hypogastric pain for six months.
Physical examination detected only rectal examination left anterolateral tumor measuring 5 to 6 cm in diameter.
Laboratory tests: hemoglobin, hematocrit, leucogram, glycemia, creatinine.
LDH and fibrinogen were normal.
IBM-1, hepatitis C and B virus negative, protein electrophoresis and negative direct and indirect Coombs test; HTLV tumorless iliac crest biopsy.
Liver biopsy was normal.
Abdominal and transrectal ultrasound: a solid hypogastric mass of low echogenicity, 67 mm x 60 mm to the left of the bladder and inside the iliac vessels, independent of the rectum and prostate.
Chest plaque was normal.
Abdominal CT: solid mass on the left side of pelvic exposition of 6.7 x 8.0 cm compressing the bladder.
The examination with intravenous contrast shows slight uptake in the tumor.
Exploratory laparotomy was performed with excision of a 6 cm diameter left paravesical tumor very attached to iliac vessels.
The pathology report showed the result of lymphoid hyperplasia with marked expansion in the mantle zone, increased eosyphiles in the interfollicular zone and vascular hypolerplasia.
Immunohistochemistry: CD20 positive in zone B of lymphoid follicles, UCHL-1 positive in zone T, CD34 positive in vessels, myeloperoxidase positive in eosinophils.
Conclusions: hyalinovascular CD with increased eosinophils.
The treatment of this patient was only surgical removal of the tumor that was followed evolving in consultation, remaining asymptomatic to date and with normal studies and CT scans.
