PRIMARY T-CELL LYMPHOMA OF THE URINARY-BLADDER

Primary malignant lymphoma of the urinary bladder is very rare. Less t han 100 cases have been reported; most are B-cell lymphomas. We report a case of primary T-cell lymphoma of the urinary bladder in a patient with a history of schistosomiasis. The patient is a 52-year-old man w ith suprapubic pain and hematuria. Examination revealed a large suprap ubic mass. Computed tomography scan of the pelvis showed a large lobul ar mass occupying the urinary bladder. No pelvic or abdominal lymphade nopathy was noted, and results of metastatic workup were negative. The patient underwent a transurethral biopsy of the bladder mass that rev ealed a diffuse large cell lymphoma that was negative for the B-cell m arker L-26 (CD 20) and positive for the T-cell marker CD-3. Polymerase chain reaction studies of the paraffin-embedded tissue revealed rearr angement of the T-cell receptor gamma gene. The patient was administer ed cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOPP) chemotherapy and currently is being treated. This case represents, to our knowledge, a very rare primary lymphoproliferative neoplasm of the urinary bladder that might represent an unusual immune response to sc histosomiasis.