Triple cancer: chronic lymphocytic leukemia with bladder and prostate carcinoma
- Author:
Smeeta Gajendra
;
Rashi Sharma
;
Manas Kumar Sahoo
- Publication Type:Case Reports
- Keywords:
synchronous malignancy;
transitional carcinoma bladder;
chronic lymphocytic leukemia;
PET/CT;
prostate adenocarcinoma
- From:The Malaysian Journal of Pathology
2015;37(2):159-163
- CountryMalaysia
- Language:English
-
Abstract:
B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a common
lymphoproliferative disorder with an increased risk of developing subsequent neoplasms of epithelial
and mesenchymal origin. The decreased immunity and B-cell dysfunction in CLL probably accounts
for this emergence of second malignancies. We report a case of synchronous bladder transitional
cell carcinoma (TCC) and prostatic carcinoma with CLL. A 74-year-old male who underwent
transurethral resection of the prostate (TURP) for benign prostatic hyperplasia 2 years before,
presented with recurrent urinary tract infection. Peripheral blood smear revealed leukocytosis
with absolute lymphocytosis (absolute lymphocyte count: 37870 cells/mm3). Flow cytometric
immunophenotyping revealed 75% abnormal lymphoid cells which were positive for CD 19, CD5,
CD23, CD22, CD200, CD20 (moderate) with lambda light chain restriction and negative for CD3,
CD10, FMC7, CD38, CD138, IgM, CD103, CD123. 18 F Fluorodeoxyglucose (FDG) positron
emission tomography/computed tomography (PET/CT) showed increased metabolic activity of the
left lateral wall of the urinary bladder extending to the left UV junction, adjacent part of trigone and
bladder neck region along with multiple heterogeneous enhancing areas with increased FDG avidity
within the prostate. Transurethral resection of the bladder tumour by cystoscopy was performed.
Histopathology showed high grade, muscle invasive urothelial carcinoma. Due to presence of
uptake in the prostate, transurethral resection of the prostate was done and histopathology revealed
adenocarcinoma of prostate (prostate specific antigen- positive), Gleason grade III+III and Gleason
score 6. A high index of suspicion is required to detect synchronous and metachronous malignancies.
Ancillary studies such as immunohistochemistry, flow cytometry and PET/CT are often essential
for detection and an accurate diagnosis.
- Full text:P020150923631110232568.pdf
