Incidental chronic lymphocytic leukemia diagnosed following radical prostatectomy for prostate cancer: A case report

Tlili, G.; Ammar, Houssem; Majdoub, Wiem; Dziri, S.; Farhat, Waad; Acacha, Emir; Rguez, Arib; Ahmed, Khaled Ben; Azzabi, A.; Jaidane, Mehdi

doi:10.1016/j.amsu.2021.102516

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Furthemore, results from follow-ups showed different prognosis of these patients. Most frequently, patients presented with recurrent prostatic carcinoma 12,[18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

What can hide an enlarged lymph node of a patient with prostatic adenocarcinoma?

et al. 2023

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Introduction. Adenocarcinoma is the most common prostatic malignancy where clinical management, Gleason score and recent updates in prostate cancer staging play critical role. Mantle cell lymphoma originates from malignant transformation of B lymphocyte in the outer edge of lymph node follicle, with pathognomonic overexpression of cyclin D1. We present a rare case of two neoplasms occurred in the same individual person. Case report. In a 68-year-old patient planned for radical prostatectomy during the hospital preoperative examinations using multislice computed tomography tumor mass confined to the prostate but also excessive lymph node enlargement were revealed. Tissue specimens were analyzed after using hematoxylin and eosin staining, as well as immunohistochemical biomarker panel. Having performed a thorough histological examination, a diagnosis of prostatic adenocarcinoma, Gleason score 3+4=7, ISUP GG2, was given. Microscopic analysis of lymph node involvement showed unexpected, diffuse proliferation of small lymphoid cells, with irregular nuclei, wide mantle zone and hyalinized blood vessels. After using immunohistochemical staining for specific markers, another diagnosis was set, and it was non Hodgkin mantle cell lymphoma. Conclusion. A prostatic adenocarcinoma can extremely rarely be in a coexistence with undiagnosed lymphoproliferative disease, such as non Hodgkin mantle cell lymphoma in our case.

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“…Furthemore, results from follow-ups showed different prognosis of these patients. Most frequently, patients presented with recurrent prostatic carcinoma 12,[18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

What can hide an enlarged lymph node of a patient with prostatic adenocarcinoma?

et al. 2023

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“…Prostate lymphoma is an uncommon entity in surgical practice and its diagnosis often poses considerable difficulty as it often mimics or is concurrent with carcinoma ( 15 – 17 ). Ultrasound, CT, and mp-MRI were the most commonly used imaging methods to detect PL and guide biopsy in the past.…”

Section: Discussionmentioning

confidence: 99%

18F-Prostate-Specific Membrane Antigen and 18F-Fluorodeoxyglucose PET/CT Unmasked the Characteristics of Prostate Lymphoma: A Case Report and Literature Review

Fan

Liang

et al. 2022

Front. Med.

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Prostate lymphoma (PL) is rarely observed and may be concurrently presented with prostate adenocarcinoma. Moreover, the appearance of PL on conventional imaging is similar with prostate adenocarcinoma. Thus, most of PL is diagnosed through prostate biopsy, or accidentally found in the specimens of surgery. Prostate-specific membrane antigen (PSMA) PET/CT has improved the management of prostate adenocarcinoma. While, the question regarding whether it benefits the discovery of the characteristics of PL is unknown. A 32-year-old man presented with worsening dysuria for 1 month, and the prostate-specific antigen (PSA) concentration was normal. While the pelvic MRI showed a mass in the prostate and multiple enlarged lymph nodes in the bilateral inguinal area. Then, the diagnosis of prostate adenocarcinoma was considered, but the serum PSA was normal and he was younger than most patients. So, 18F-PSMA PET/CT was then performed to further reveal the characteristics of the lesion and guide biopsy. However, there was no abnormal PSMA uptake in the lesion of the prostate and lymph nodes of the pelvic cavity and bilateral inguinal area. These lesions presented with increased glucose metabolism on fluorodeoxyglucose (FDG) PET/CT, and the prostate biopsy was then performed. PL was confirmed based on the results of the histopathologic examination, and the patient subsequently received systemic chemotherapy plus radiotherapy. Fortunately, the symptoms and the lesions completely disappeared after radiotherapy. The clinical symptoms of PL are atypical, and PL and adenocarcinoma may be concurrently presented. Moreover, distinguishing PL from prostate adenocarcinoma based on the appearance of conventional imaging is difficult. As opposed to prostate adenocarcinoma, a high FDG-avidity and low PSMA uptake by lymphoma either in the prostate or metastases are seen. So, PSMA PET/CT combined with FDG PET/CT can non-invasively identify the characteristics and origin of PL.

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Extramedullary and extranodal manifestations in chronic lymphocytic leukemia – an update

Robak,

Puła,

Braun

et al. 2024

Ann Hematol

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Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a common leukemia characterized by clonal expansion of mature CD5+/CD23 + B cells in the blood, bone marrow (BM) and lymphoid tissues. CLL can undergo extramedullary and extranodal infiltration, with one study noting an incidence of only 0.3 per 100,000 people, and in 17.6% of CLL patients in another report. The most common extranodal sites of leukemic involvement are the skin and central nervous system; however, other organs, including liver, lungs, kidney, gastrointestinal tract, bone, prostate and heart, are occasionally involved. The prognostic significance of extra-medullary CLL is still under debate, but the prognosis in such patients seems to be better in the era of novel targeted drugs. Following a diagnosis of extranodal CLL, survival appears to depend on the site of infiltration. This review presents an overview of CLL in patients with extramedullary and extranodal leukemic lesions, focusing on its epidemiology, pathogenesis, prognosis, clinical characteristics and treatment results.

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Incidental chronic lymphocytic leukemia diagnosed following radical prostatectomy for prostate cancer: A case report

Cited by 4 publications

References 14 publications

What can hide an enlarged lymph node of a patient with prostatic adenocarcinoma?

What can hide an enlarged lymph node of a patient with prostatic adenocarcinoma?

18F-Prostate-Specific Membrane Antigen and 18F-Fluorodeoxyglucose PET/CT Unmasked the Characteristics of Prostate Lymphoma: A Case Report and Literature Review

Extramedullary and extranodal manifestations in chronic lymphocytic leukemia – an update

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