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Bladder
Other tumors
Lymphoma (primary)
Author: Nat Pernick, M.D. (see Authors page)
Revised: 27 December 2009, last major update - December 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Either primary (rare, originating in bladder with no known lymphoma elsewhere) or secondary (much more common)
Terminology
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Epidemiology
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● Secondary bladder involvement occurs in 10-25% of leukemias / lymphomas
● Rare as primary; <100 cases
● MALT is most common subtype in bladder; typically affects adults > 60 years, 75% female
● Diffuse large B cell lymphoma is also common, and may arise from transformation of MALT (J Clin Pathol 2000;53:458)
Sites
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Etiology
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Clinical features
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● Recurrent lymphoma in bladder is associated with widely disseminated disease and poor prognosis (AJSP 1997;21:1324)
Low grade MALT lymphoma
● Most common lymphoma subtype in bladder
● Much more common as secondary tumor than primary tumor
● History of chronic cystitis common (Archives 2001;125:332)
● Long median survival for either primary lymphomas of bladder or lymphomas with initial presentation in bladder but other coexisting disease (AJSP 1997;21:1324)
Prognostic factors
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● Histologic subtype, stage
Case reports
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● 52 year old man with schistosomiasis and T cell lymphoma (AJSP 1998;22:373)
● 67 year old woman with EBV+ B cell lymphoproliferative disorder (Indian J Urol 2009;25:129)
● 72 year old woman with exophytic mass at bladder base and MALT lymphoma (Mod Path 1993;6:145)
● 75 year old woman with diffuse large B cell lymphoma (Intern Med 2009;48:1403)
● Elderly woman with B cell lymphoma with signet-ring cells (Arch Pathol Lab Med 1991;115:635)
Treatment
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● MALT: radiation therapy, usually no recurrences
Clinical images
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Gross description (Macroscopy)
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● Discrete tumors, usually large and centered in dome or lateral walls
Gross images
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Micro description (Histopathology)
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● MALT: sheets of low grade, uniform cells that surround and separate, but don’t destroy muscle fascicles
Micro images
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MALT
Bland lymphocytes fill lamina propria but don’t involve urothelium #1; #2
Lymphocytes permeate muscle fascicles
Monocytoid cells with clear cytoplasm
EBV+ B cell lymphoproliferative disorder
Diffuse infiltrate of atypical lymphocytes; CD20+; CD30+; EBER+
Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Urothelial carcinoma with prominent lymphoid infiltrate: See AJSP 1991;15:569
Additional references
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End of Bladder > Other tumors > Lymphoma
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