How common is prostatic involvement by lymphoma and leukemia?

Updated: Dec 22, 2019
  • Author: Joshua I Warrick, MD; Chief Editor: Liang Cheng, MD  more...
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Prostatic involvement by lymphoma and leukemia is rare in surgical pathology practice, identified in less than 1% of prostate specimens. [1, 2, 3]

Terris et al evaluated 1,092 consecutive radical prostatectomy specimens, and pelvic lymph nodes if available, removed for prostatic adenocarcinoma. [1] They found 1.2% of cases involved leukemia or lymphoma: nine chronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLLs), three Hodgkin lymphomas, and one hairy cell leukemia. In total, 0.8% (nine cases) demonstrated prostate and lymph node involvement, whereas 0.4% (four cases) showed lymph node involvement only. Five (38.5%) patients had preoperative lymphocytosis. [1]

Similarly, Chu et al evaluated 4,831 consecutive prostate specimens (3,405 biopsies, 266 transurethral resections, and 1,160 prostatectomies). [2] They found that 15 (0.3%) cases demonstrated involvement by leukemia or lymphoma: 8 CLL/SLLs, 2 marginal-zone lymphomas, 2 mantle cell lymphomas, 2 diffuse large B-cell lymphomas (DLBCLs), and 1 follicular lymphoma. [2]

Combined, these studies suggest CLL/SLL is the most common type of leukemia/lymphoma to involve the prostate in routine specimens, and it is usually seen in association with involvement at different sites, particularly the pelvic lymph nodes.

More recently, there have been case reports of an elderly Indian male with synchronous bladder taransitional cell carcinoma (TCC) and prostatic carcinoma with CLL (triple cancer), [4]  a senior Serbian patient with synchronous mantle cell lymphoma and prostate adenocarcinoma, [5]  and an elderly Czech patient with mantle cell lymphoma and prostate adenocarcinoma. [6] Non-Hodgkin lymphoma of the prostate, albeit rare, also occurs; Galante et al has described the longitudinal clinical course of a case that was refractory to treatment. [7]

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