title: An unusual pathological finding of chronic lymphocitic leukemia and adenocarcinoma of the prostate after transurethral resection for complete urinary retention: case report.
abstract: BACKGROUND
  We describe a patient who underwent transurethral resection of the prostate for urinary obstructive symptoms and had histological findings of adenocarcinoma of the prostate with prostatic localization of chronic lymphocitic leukemia (CLL). The contemporary presence of CLL, adenocarcinoma of the prostate and residual prostatic gland after transurethral resection has never been reported before and the authors illustrate how they managed this unusual patient.
  
  
  METHODS
  A 79-years-old white man, presented with acute urinary retention, had a peripheral blood count with an elevated lymphocytosis (21.250/mL) with a differential of 65.3% lymphocytes and the prostate-specific antigen (PSA) value was 3.38 ng/mL with a percent free PSA of 8.28%. The transrectal ultrasound (TRUS) indicated an isoechonic and homogenic enlarged prostate of 42 cm3 and the abdomen ultrasound found a modest splenomegaly and no peripheral lymphadenophaty. The patient underwent transurethral resection of the prostate and had a pathological finding of adenocarcinoma in the prostate with a Gleason Score 4 (2+2) of less than 5% of the material (clinical stage T1a), associated with a diffused infiltration of chronic lymphocitic leukemia elements.
  
  
  CONCLUSIONS
  The incidental finding of a prostatic localization of a low-grade non-Hodgkin's lymphoma does not modify eventually further treatments for neither prostate cancer nor lymphoma. The presence of a low-grade and low-stage lymphoma, confirmed by a hematological evaluation, and the simultaneous evidence of an adenocarcinoma after transurethral resection of the prostate for acute urinary retention do not require any immediate treatment due to its long-term survival rate and the follow-up remains based on periodical PSA evaluation and complete blood count.
authors.affiliation: Divisione Clinicizzata d'Urologia, University of Verona, Verona, Italy. riccardo.ballario@virgilio.it
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ballario
authors.forename: Paolo
authors.initials: P
authors.lastname: Beltrami
authors.forename: Stefano
authors.initials: S
authors.lastname: Cavalleri
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ruggera
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Zorzi
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology*; D000368:Aged; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000473:pathology*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology*; D020728:Transurethral Resection of Prostate; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery