IMR Press / EJGO / Volume 40 / Issue 1 / DOI: 10.12892/ejgo4630.2019
Open Access Case Report
Anaplastic T-cell lymphoma of the urinary bladder with unspecific clinical and radiological characteristics - a unique case report
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1 Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
2 Department of Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
3 Clinic of Obstetrics and Gynecology, Clinical Centre of Serbia, Belgrade, Serbia
4 Medical Faculty, University of Belgrade, Belgrade, Serbia
5 Center for Anesthesiology and Resuscitation, Clinical Center of Serbia, Belgrade, Serbia
6 Department for Urological Histopathology, Clinical Center of Serbia, Belgrade, Serbia
7 Department of Cellular Pathology, PathLinks Pathology Services, Lincoln County Hospital, Lincoln, United Kingdom
8 Department of Obstetrics and Gynecology “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
9 Versys Clinics Budapest Human Reproduction Institute, Budapest, Hungary
Eur. J. Gynaecol. Oncol. 2019 , 40(1), 136–139; https://doi.org/10.12892/ejgo4630.2019
Published: 10 February 2019
Abstract

Purpose: To report a case of extremely rare anaplastic T-cell lymphoma of the urinary bladder in an advanced stage, with completely unspecific radiological features and symptomatology mimicking necrotic myomas. Case Report: A 38-year-old women was admitted for pelvic pain, dysuria, enlarged uterus, subfebrile temperature, but without vaginal bleeding and hematuria. On ultrasound scan necrosis of the uterine myomas was suspected. Magnetic resonance imaging revealed an anteuterine tumor (9×9×11 cm) infiltrating the uterus and urinary bladder and retrouterine formation (7×5×7 cm) adhering to the posterior uterine wall and rectum, right kidney hydronephrosis, and parailiac lymphadenopathy. Cystoscopy confirmed the presence of the tumor on the posterior bladder wall and bladder roof infiltrating the right ureteral orifice. Histopathological and immunohistochemical analyses of tumor biopsy confirmed the presence of T-cell anaplastic ALK+ non Hodgkin’s lymphoma of the urinary bladder. Conclusion: This case report shows that pelvic pain and dysuria alone can imply on urinary bladder tumors even in the absence of hematuria. Additionally, uniqueness of this case lies in the younger age of the female patient. Moreover, the authors showed for the first time that lymphomas could spread locally into both uterus and intestines, without systemic dissemination.

Keywords
Urinary bladder
T-cell lymphoma
Pelvic pain
Dysuria
Necrotic uterine myoma
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