Primary low-grade lymphoma of mucosa-associated lymphoid tissue of the urinary bladder: A case report with special reference to the use of ancillary diagnostic studies

Ko Ando, Yoshihiro Matsuno, Yae Kanai, Michiie Sakamoto, Hiroyuki Fujimoto, Masaru Narabayashi, Ken Ichi Tobisu

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We report a case of primary low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type of the urinary bladder. The patient, a 77-year-old woman, presented with a sense of urinary retention. An intravenous pyelogram and cystoscopy revealed a wide-based submucosal mass measuring 3 cm in the left wall of the urinary bladder. Histological findings of the tissue obtained by transurethral resection (TUR) showed a dense, monomorphic atypical lymphoid (centrocyte-like) infiltrate with reactive lymph follicles in the subepithelial tissue. Monocytoid and plasmacytoid features were readily evident in a population of these cells. Lymphoepithelial lesions involving the urothelium were also noticed in some areas. These features were strongly suggestive of primary low-grade lymphoma of the MALT type. The diagnosis was confirmed by immunohistochemical and flow cytometric studies, both of which showed a clear immunoglobulin restriction to lambda light chain and also by polymerase chain reaction-based assay using a formalin-fixed paraffin-embedded TUR tissue sample, which showed a clonal Ig heavy-chain gene rearrangement. Clinical staging procedures revealed that the tumor was localized in the urinary bladder. The patient has not received chemotherapy and is alive and well with no evidence of recurrence, 3 years after TUR. This case demonstrates that these ancillary tests are worth performing for confirmation of B-cell clonality in TUR tissue samples showing dense B-lymphocytic infiltration.

Original languageEnglish
Pages (from-to)636-639
Number of pages4
JournalJapanese journal of clinical oncology
Issue number12
Publication statusPublished - 1999 Jan 1
Externally publishedYes



  • Flow cytometry
  • Immunohistochemistry
  • Malignant lymphoma
  • Polymerase chain reaction
  • Urinary bladder

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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