title: [Malignant lymphoma of the prostate--diagnosis on the second biopsy].
abstract: BACKGROUND
  Malignant lymphoma of the prostate is rare. In the literature, about 165 cases with either a primary lymphoma of the prostate or secondary infiltration of the prostate by a lymphoma are described.
  
  
  METHODS
  The case of a 59-year-old patient with an irregular tumor in the prostatic region, but normal prostate-specific antigen (PSA), a fracture in the vertebral column and a bilateral enlargement of the suprarenal glands is presented. Repetitive prostate biopsy revealed the diagnosis of a diffuse large B cell lymphoma. Further staging examinations gave hints to an epidural infiltration. A polychemotherapy including intrathecal drug applications was initiated. Staging after four therapeutic cycles already showed good partial remission of all lymphoma manifestations. After two further therapeutic cycles, a CT scan showed a small rest of prostatic bulk, but PET-CT did not detect vital lymphatic tissue (complete remission).
  
  
  CONCLUSIONS
  In cases of irregular prostatic enlargements, carcinoma has to be considered as the most frequent diagnosis. Nevertheless, also a solitary lymphoma or infiltration of the prostate by a systemic lymphoma has to be taken into account, especially if the PSA value is in the normal range.
authors.affiliation: Klinik und Poliklinik für Allgemeine Innere Medizin, Inselspital Bern, Universität Bern, Schweiz.
authors.forename: Gabi
authors.initials: G
authors.lastname: Vetsch
authors.forename: Christa K
authors.initials: CK
authors.lastname: Baumann
authors.forename: Marco
authors.initials: M
authors.lastname: Kläy
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leupin
authors.forename: Cyrill
authors.initials: C
authors.lastname: Rentsch
authors.forename: Esther
authors.initials: E
authors.lastname: Mueller-Garamvölgyi
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bürgi
authors.forename: Uwe
authors.initials: U
authors.lastname: Schiemann
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000627:therapeutic use; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D017430:Prostate-Specific Antigen; D011241:Prednisone