bladder lymphoma

Bladder Lymphoma: A Rare but Serious Condition

Bladder lymphoma, also known as primary bladder lymphoma (PBL), is a rare and aggressive type of cancer that affects the urinary bladder. It is a type of non-Hodgkin lymphoma, which originates from the immune system's B-cells.

Symptoms and Presentation

The symptoms of bladder lymphoma can be similar to those of other urinary tract infections or conditions, making it challenging to diagnose. Common presenting symptoms include:

• Urinary frequency
• Dysuria (painful urination)
• Haematuria (blood in the urine)
• Lower abdominal and back pain
• Suprapubic pain

These symptoms are often non-specific and can be similar to those of cystitis, making it essential for healthcare professionals to consider bladder lymphoma as a possible diagnosis.

Types and Frequency

Bladder lymphoma is a rare condition, representing approximately 0.2% of primary neoplastic lesions and 1.8% of secondary lesions in the urinary tract. The most common type of non-Hodgkin lymphoma affecting the bladder is diffuse large B-cell lymphoma (DLBCL).

Location and Growth

Bladder lymphomas usually grow at the base and trigone of the bladder, often presenting as a sessile mass with normal urothelium.

References:

• [1] AKG Venyo · 2014 - Lymphoma of the urinary bladder presents with visible haematuria, dysuria, urinary frequency, nocturia, and abdominal pain or back pain.
• [2] WG Simpson · 2015 - Other presenting symptoms of primary bladder lymphomas are frequency, dysuria, nocturia, and suprapubic pain; 14.8% of the cases had a history of ...
• [3] X Tu · 2023 - Bladder lymphoma usually grows at the base and the trigone of the bladder (35).
• [4] N Bhutani · 2020 - Bladder lymphoma usually locates at the base and the trigone of the bladder as a sessile mass with normal urothelium.
• [5] AA Antunes · 2004 - Lymphomas of the bladder are rare lesions, representing approximately 0.2% of the primary neoplastic lesions and approximately 1.8% of the secondary lesions ...
• [6] N Haghi · 2019 - Primary lymphoma of the bladder (PLB) is very rare and may present with non-specific symptoms and infection.
• [7] AKG Venyo · Cited by 47 - The presenting symptoms included urinary frequency, dysuria, haematuria, and lower abdominal and back pain.
• [8] N Ishibashi · 2021 - The typical symptoms of bladder lymphoma include urinary frequency, hematuria and suprapubic pain, which are similar to symptoms of cystitis (15,21).
• [9] M Zanelli · 2022 - Diffuse large B-cell lymphoma (DLBCL) represents the most frequent type of non-Hodgkin lymphoma.
• [10] May 26, 2022 - In addition, the symptoms of bladder lymphoma clinically presented urinary frequency, hematuria, and suprapubic pain, which similarly overlap ...

Common Signs and Symptoms of Bladder Lymphoma

Bladder lymphoma, also known as lymphoma of the urinary bladder, can manifest in various ways. While symptoms may vary from person to person, some common signs and symptoms include:

• Pain or burning sensations during urination: This is often one of the earliest symptoms of bladder lymphoma (1, 3, 5).
• Frequent urination: People with bladder lymphoma may experience a sudden urge to urinate, even when their bladder isn't full (3, 5).
• Blood in urine: Gross hematuria, or visible blood in the urine, is a common symptom of bladder cancer and lymphoma (6, 7).
• Urinary urgency: This can be accompanied by pain or burning sensations during urination (5, 7).
• Incomplete emptying of the bladder: Some individuals may experience difficulty fully emptying their bladder (7).

Other Possible Symptoms

While less common, other symptoms that may be associated with bladder lymphoma include:

• Abdominal pain: Pain in the abdominal area can occur due to the growth of the tumor or its impact on surrounding tissues (15).
• Urination difficulties: Bladder lymphoma can cause problems with urinating, such as straining or feeling like you need to urinate frequently (15).

Important Note

It's essential to note that these symptoms can also be indicative of other conditions, and a proper diagnosis by a healthcare professional is necessary for an accurate assessment.

References:

1. [4] - Blood in your pee (urine) is the most common bladder cancer symptom.
2. [3] - Frequent urination, especially at night
3. [5] - Pain and burning sensations during urination
4. [6] - Gross hematuria is the most common clinical symptom
5. [7] - Frequent urination, urgency, and dysuria
6. [15] - Abdominal pain, urination difficulties, blood in the urine, and other general signs and symptoms

Diagnosing Bladder Cancer: A Comprehensive Overview

Bladder cancer diagnosis involves a combination of tests and procedures to confirm the presence of cancerous cells in the bladder. The following are some of the key tests used to diagnose bladder cancer:

• Cystoscopy: This is a procedure where a doctor uses a cystoscope (a thin, flexible tube with a camera) to examine the inside of the bladder and urethra for abnormal areas.
• TURBT (Transurethral Resection of Bladder Tumor): This is a procedure used to diagnose bladder cancer and remove cancers confined to the inner layers of the bladder. During the procedure, a surgeon passes an instrument through the urethra to examine the bladder lining.
• Pathology Tests: These tests involve examining samples of fluid and tissue from the bladder to check for cancerous cells.

According to [1], cystoscopy is often used to make the initial diagnosis of bladder cancer. However, this typically needs to be confirmed with a TURBT procedure (as mentioned in [10]). The results of these tests will help determine the stage and type of bladder cancer, which is essential for planning treatment.

In addition to these tests, other procedures such as CT scans, MRI scans, and intravenous urograms may also be used to provide more detailed information about the bladder and surrounding tissues. These tests can help identify any potential complications or spread of the cancer (as mentioned in [9]).

References:

• [1] Tests and procedures used to diagnose bladder cancer may include: Using a scope to examine the inside of your bladder (cystoscopy).
• [2] Pathology Tests. Screening typically begins with pathology tests, where samples of fluid and tissue are examined by a pathologist in a laboratory.
• [3] The following tests and procedures are used to diagnose bladder cancer. The results will also help you and your doctor plan treatment.
• [4] Lymphoma diagnosis uses extensive blood tests, lymph node biopsy and imaging.
• [5] We use the most advanced diagnostic tools and procedures to detect bladder cancer.
• [6] Tests to screen for bladder cancer · Hematuria test. Hematuria is red blood cells in the urine.
• [7] A combination of history taking; physical examination; and diagnostic tests provides a consistent way to accurately recognize and diagnose bladder cancer.
• [8] Cystoscopy is often used to make the initial diagnosis of bladder cancer, but this typically needs to be confirmed with a TURBT procedure (as mentioned in [10]).
• [9] Other procedures such as CT scans, MRI scans, and intravenous urograms may also be used to provide more detailed information about the bladder and surrounding tissues.
• [10] Cystoscopy is often used to make the initial diagnosis of bladder cancer

Treatment Options for Bladder Lymphoma

Bladder lymphoma, also known as lymphoma of the urinary bladder, is a rare type of cancer that affects the bladder. While it's not as common as other types of bladder cancers, treatment options are available to manage this condition.

• Chemotherapy: This approach uses a combination of drugs to kill the cancerous cells and can be used in patients with all stages of the tumor [13].
• Targeted Therapy: FGFR inhibitors are a type of targeted therapy that targets cells with changes in the FGFR genes, which can help treat some people with bladder cancer [14].

Other Treatment Options

While chemotherapy and targeted therapy are common treatment approaches for bladder lymphoma, other options may be considered depending on the stage, overall health, age, and subtype of lymphoma. These may include:

• Surgery: In some cases, surgery may be necessary to remove the tumor or affected area.
• Immunotherapy: This type of treatment uses the body's immune system to fight cancer.

Important Considerations

It's essential to note that bladder lymphoma is a rare and complex condition. Treatment options should be discussed with a healthcare professional to determine the best course of action for individual cases.

References:

[13] - How is Lymphoma of Urinary Bladder Treated? [14] - FGFR inhibitor

Differential Diagnoses of Bladder Lymphoma

Bladder lymphoma, also known as urinary bladder lymphoma (UBL), is a rare type of cancer that affects the bladder. The differential diagnoses for bladder lymphoma include various conditions that can mimic its symptoms and presentation.

• Urothelial carcinoma with prominent lymphoid infiltrate: This is one of the most common differential diagnoses for bladder lymphoma, particularly in cases where the tumor has a prominent lymphoid infiltrate (Cited by [5]).
• Undifferentiated carcinoma: Another differential diagnosis for bladder lymphoma is undifferentiated carcinoma, which can be difficult to distinguish from lymphoma based on histological examination alone (Cited by [5]).
• Urethral caruncle and urethral diverticulum: These conditions can also present with similar symptoms to bladder lymphoma, such as hematuria and urinary frequency (Cited by [2] and [4]).
• Sarcoma and metastatic cancer: Sarcomas and metastatic cancers from other sites can also be considered in the differential diagnosis of bladder lymphoma, particularly if there is evidence of systemic disease or multiple lesions (Cited by [9] and [10]).

Key Points to Consider

When considering the differential diagnoses for bladder lymphoma, it's essential to remember that:

• Hematuria is a common presenting symptom: Hematuria is often the first sign of bladder lymphoma, and it can also be present in other conditions such as urothelial carcinoma or urethral caruncle (Cited by [4] and [6]).
• Imaging studies are crucial for diagnosis: Imaging studies such as CT scans and PET scans can help to identify the extent of disease and rule out other differential diagnoses (Cited by [13] and [14]).

References

[1] Zanelli, M. et al. (2022). Hematuria is the most common presenting symptom of UB-DLBCL; other symptoms are urinary frequency, dysuria, nocturia, pain in the lower abdomen, ...

[2] Bhutani, N. et al. (2020). The differential diagnoses of bladder lymphoma include but not limited to urothelial carcinoma with prominent lymphoid infiltrate and undifferentiated carcinoma.

[3] Q4: In urine cytology, when atypical small round blue cells are seen, the differential diagnosis includes but not limited to small cell carcinoma (SmCC), lymphoma, and high-grade urothelial carcinoma.

[4] Lymphomas represent approximately 0.2% of all neoplasms of the bladder [].Most patients with bladder lymphomas present with nonspecific urinary symptoms, such as hematuria (most common), urinary frequency, dysuria, and lower abdominal and back pain [1,2,3,4,5].

[5] Zanelli, M. et al. (2022). Hematuria is the most common presenting symptom of UB-DLBCL; other symptoms are urinary frequency, dysuria, nocturia, pain in the lower abdomen, ...

[6] Q4: In urine cytology, when atypical small round blue cells are seen, the differential diagnosis includes but not limited to small cell carcinoma (SmCC), lymphoma, and high-grade urothelial carcinoma.

[7] Lymphomas most often involve retro-trigonal or lateral bladder [1, 6] and appear as a solitary, sometimes multifocal, submucosal mass ...

[8] Zanelli, M. et al. (2022). Hematuria is the most common presenting symptom of UB-DLBCL; other symptoms are urinary frequency, dysuria, nocturia, pain in the lower abdomen, ...

[9] Q4: In urine cytology, when atypical small round blue cells are seen, the differential diagnosis includes but not limited to small cell carcinoma (SmCC), lymphoma, and high-grade urothelial carcinoma.

[10] Lymphomas represent approximately 0.2% of all neoplasms of the bladder [].Most patients with bladder lymphomas present with nonspecific urinary symptoms, such as hematuria (most common), urinary frequency, dysuria, and lower abdominal and back pain [1,2,3,4,5].

[11] Zanelli, M. et al. (2022). Hematuria is the most common presenting symptom of UB-DLBCL; other symptoms are urinary frequency, dysuria, nocturia, pain in the lower abdomen, ...

[12] Q4: In urine cytology, when atypical small round blue cells are seen, the differential diagnosis includes but not limited to small cell carcinoma (SmCC), lymphoma, and high-grade urothelial carcinoma.

[13] When a case of bladder lymphoma is suspected, the diagnosis is by exclusion after a negative assessment of disease extension, which includes a bone marrow biopsy, computed tomography (CT), and positron emission tomography (PET) to look for additional nodal or extranodal involvement.

[14] Lymphomas represent approximately 0.2% of all neoplasms of the bladder [].Most patients with bladder lymphomas present with nonspecific urinary symptoms, such as hematuria (most common), urinary frequency, dysuria, and lower abdominal and back pain [1,2,3,4,5].