Prostate
Other malignancies
Lymphoma

Authors: Kenneth A. Iczkowski, M.D. (see Authors page)

Revised: 8 February 2017, last major update February 2017

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: prostate lymphoma
Cite this page: Lymphoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/prostatelymphoma.html. Accessed October 22nd, 2017.
Definition / general
  • Most cases (~ 48%) represent secondary lymphoma; ~ 35% represent primary lymphoma; the remainder are unclassifiable
    • Secondary: 30 of 62 patients (48%) with previously documented lymphoma at other sites developed prostatic involvement constituting secondary prostatic lymphoma
    • Primary: 22 of 62 patients (35%) presented with primary extranodal lymphoma of the prostate; that is, no patient had hepatosplenomegaly, inguinal lymphadenopathy or an abnormal complete blood count at presentation
    • Unclassifiable: the remaining 10 patients (Cancer 1998;83:732); among this group, 2 of 62 patients had Hodgkin lymphoma of the prostate
  • In other series, a similar distribution of lymphoma types occurred (Am J Surg Pathol 2005;29:693)
Essential features
  • Most cases (~ 48%) represent secondary lymphoma; ~ 35% represent primary lymphoma; the remainder are unclassifiable
  • The most common primary and secondary lymphoma subtype is diffuse large B cell lymphoma, followed by SLL and follicular center cell lymphoma
  • Leukemia rarely involves the prostate, with myeloid sarcoma (chloroma) being the most commonly reported tumor, either as the initial presentation of leukemia (Am J Hematol 1996;53:267, Lancet Oncol 2004;5:62) or as a site of relapse (Urol Oncol 2005;23:419)
Epidemiology
Clinical features
  • Most patients had bladder outlet obstruction and prostatic enlargement, with incomplete voiding; some were asymptomatic
  • The degree of firmness of the prostate on rectal examination is usually less than in carcinoma (Cancer 1998;83:732)
  • Histologic subtypes of primary lymphoma (Cancer 1998;83:732) in 22 patients included:
    • Diffuse large B cell (12 patients)
    • Small lymphocytic (4 patients)
    • Follicular center cell, diffuse, small cell (2 patients)
    • Follicular center cell, Grade 1 (according to the revised European-American classification, small cleaved) (1 patient)
    • Follicular center cell, Grade 2 (mixed) (1 patient)
    • High grade B cell lymphoma, Burkitt-like (2 patients)
  • A tendency was noted in all case series for small lymphocytic leukemia and mantle cell lymphoma to be more likely to involve the prostate secondarily than to present as primary to the prostate (Am J Surg Pathol 2005;29:693)
  • Secondary lymphoma (Cancer 1998;83:732) in 30 patients included:
    • Small lymphocytic (8 patients, all with concomitant leukemia)
    • Follicular center cell lymphoma, diffuse, small cell (2 patients)
    • Follicular center, Grade 1 (small cell) (1 patient)
    • Follicular center, Grade 2 (1 patient)
    • Diffuse large B cell (11 patients)
    • Peripheral T cell lymphoma (2 patients)
    • High grade B cell lymphoma, Burkitt-like (1 patient)
    • Burkitt lymphoma (1 patient)
    • Hodgkin lymphoma (nodular sclerosing in 1 patient and mixed cellularity in 1 patient)
    • Unknown (1 patient)
Diagnosis
Prognostic factors
  • Lymphoma specific survival was 64% at 1 year (95% confidence interval (CI), 51% - 80%), 50% at 2 years (95% CI, 36% - 68%), 33% at 5 and 10 years and 16% at 15 years (Cancer 1998;83:732)
Case reports
Treatment
  • Diffuse large B cell lymphoma: R-CHOP chemotherapy (J Can Res Ther 2015;11:977)
  • Small lymphocytic lymphoma: radiation therapy for symptoms
Microscopic (histologic) description
  • The two most common phenotypes are:
    • Diffuse large B cell lymphoma: large cleaved cells with nucleoli and marked pleomorphism
    • CLL / Small lymphocytic lymphoma: diffuse architectural effacement, replacement of sinuses by tumor cells, pseudofollicles usually present, lack of cortical follicles
Microscopic (histologic) images

Images hosted on other servers:

MALT lymphoma

Mantle cell lymphoma


SLL and other disorders

Diffuse large B cell lymphoma

Follicular lymphoma

Positive stains
  • See the Lymphoma chapter for a listing of immunophenotypes of the various lymphomas