Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Prognostic factors | Case reports | Treatment | Radiology description | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosisCite this page: Levy G. Lymphoma (primary). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderlymphoma.html. Accessed May 24th, 2020.
Definition / general
- Either primary (rare, originating in bladder with no known lymphoma elsewhere) or secondary (much more common)
Epidemiology
- Female predominance, most cases are in middle aged women
- Secondary bladder involvement occurs in 10-25% of leukemias / lymphomas and in advanced stage systemic lymphoma
- 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
- Bladder, lower ureteral tract
Clinical features
- Comprises 5% of non-urothelial tumors of urothelial tract
- Long median survival for either primary lymphoma of bladder or lymphoma with initial presentation in bladder but other coexisting disease (Am J Surg Pathol 1997;21:1324)
- Recurrent lymphoma in bladder is associated with widely disseminated disease and poor prognosis
- Presents with gross hematruia, dysuria, urinary frequency, nocturia, and abdominal or back pain
- Low grade MALT lymphoma: most common lymphoma subtype in bladder; much more common as secondary tumor than primary tumor; history of chronic cystitis common (Arch Pathol Lab Med 2001;125:332)
Prognostic factors
- Histologic subtype, stage
Case reports
- 52 year old man with schistosomiasis and T cell lymphoma (Am J Surg Pathol 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 Pathol 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
- MALT: radiation therapy, usually no recurrences
Radiology description
- Submucosal masses: 70% of cases are solitary mass, 20% of cases are multiple masses, and 10% of cases show diffuse wall thickening
Gross description
- Discrete tumors, usually large and centered in dome or lateral walls
Microscopic (histologic) description
- MALT: sheets of low grade, uniform cells that surround and separate, but don't destroy muscle fascicles
Microscopic (histologic) images
Images hosted on other servers:
Bland lymphocytes fill lamina propria but don’t involve urothelium
Lymphocytes permeate muscle fascicles
Monocytoid cells with clear cytoplasm
Fig 1: MALT involving lamina propria
Cytology description
- MALT: monomorphic small to medium sized lymphocytes
Positive stains
Negative stains
Molecular / cytogenetics description
- MALT Lymphoma: t(11;18) (q21:21)
Differential diagnosis
