Next Article in Journal
The Role of Magnetic Resonance Imaging in Penile Fracture Management—A Systematic Review
Previous Article in Journal
Is YouTube a Reliable Source of Information for Sacral Neuromodulation in Lower Urinary Tract Dysfunction?
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
SIUJ
Volume 6
Issue 2
10.3390/siuj6020028
siuj-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Systematic Review

Features and Management of Incidental Prostatic Lymphoma Obtained in Lower Urinary Tract Symptoms Surgery: A Systematic Review

by
Jeremy Cheng
1,
Samith Minu Alwis
1,
Nathan Papa
1,2,3,
Joseph Ischia
1,4,
Damien Bolton
1,4 and
Dixon Woon
1,4,*
1
Department of Urology, Austin Health, Melbourne 3084, Australia
2
School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia
3
Garvan Institute of Medical Research, Sydney 2010, Australia
4
Department of Surgery, University of Melbourne, Melbourne 3010, Australia
*
Author to whom correspondence should be addressed.
Soc. Int. Urol. J. 2025, 6(2), 28; https://doi.org/10.3390/siuj6020028
Submission received: 23 February 2025 / Revised: 26 March 2025 / Accepted: 31 March 2025 / Published: 17 April 2025
Browse Figure
Versions Notes

Abstract

:
Background/Objectives: Prostatic lymphoma is a rare malignant tumour that frequently causes urinary tract obstruction. It is uncommon for patients to present with systemic features or B-symptoms. As a result, it is often diagnosed incidentally during surgical lower urinary tract symptoms (LUTS) treatment. This systematic review aims to identify any common clinical features of prostatic lymphoma diagnosed incidentally during surgical LUTS treatment and summarise disease treatment and outcomes. Methods: The study protocol was registered with Prospective Register of Systematic Reviews (PROSPERO). A search was performed across the following electronic databases: MEDLINE, Embase, Web of Science, and Cochrane Database of Systematic Reviews. Full texts of eligible studies were analysed and data were extracted. The review was performed in accordance with PRISMA guidelines. Results: A total of 24 case reports compromising 25 cases were included. The median (IQR) age was 67 (61–73) years. All patients reported LUTS as their primary complaint, and the median duration of LUTS prior to diagnosis was 17 (4–44) months. Serum prostate-specific antigen (PSA) was normal in 10 cases and prostatomegaly present on imaging in 16 cases. A total of 10 different subtypes of lymphoma were reported. Extra-prostatic involvement was reported in eight patients. Chemotherapy, with or without adjuvant radiotherapy, was the mainstay of lymphoma treatment. The majority of articles reported positive outcomes, with complete remission in 17 cases. Conclusions: Prostatic lymphoma is a difficult clinical diagnosis due to its similar presentation to benign prostatic hyperplasia (BPH). Although rare, prostatic lymphoma may need to be considered as a diagnosis in patients with an atypical presentation of BPH. Prognosis is often favourable after prompt referral to haematology or oncology.

1. Introduction

Prostatic lymphoma is a rare malignant tumour, with primary lymphoma of the prostate accounting for 0.1% of all newly diagnosed lymphomas and less than 0.09% of all prostate neoplasms [1]. Diagnosis is most often made in the seventh decade of life during surgical treatment for lower urinary tract symptoms (LUTS) or investigation and treatment of prostate adenocarcinoma, with a rate of up to 0.17% in prostate biopsy, prostatectomy, and transurethral resection of the prostate (TURP) specimens [2,3].
Prostatic lymphoma frequently causes urinary tract obstruction, and patients may present with LUTS such as urgency, hesitancy, weak urinary stream, and acute urinary retention (AUR) [2,4]. Results from traditional diagnostic tools such as digital rectal examination (DRE) and serum prostate-specific antigen (PSA) are often indistinguishable from those found in benign prostatic hyperplasia (BPH), highlighting the challenges in diagnosing prostatic lymphoma [2,5]. DRE often mimics BPH, with most cases demonstrating a diffusely enlarged or nodular gland [2]. Similarly, there is no clear relationship between PSA and prostatic lymphoma, with PSA generally not elevated [5]. It is uncommon for patients to present with systemic features or B-symptoms of lymphoma such as fever, weight loss, and night sweats [4]. Consequently, diagnosis of prostatic lymphoma is often incidentally made during histopathological review of prostatic tissue obtained from surgical LUTS treatment.
No systematic review exists exploring incidental prostatic lymphoma diagnosed during surgical LUTS treatment. There are limited case series describing prostatic lymphoma; however, these contain a large proportion of cases in which lymphoma was already a suspected or known diagnosis, and furthermore lack clinical details such as initial patient presentation and eventual treatment [3,4]. In addition, due to its rarity, there is no consensus on the optimal treatment of prostatic lymphoma [6]. This systematic review aims to identify any common clinical features of incidental prostatic lymphoma diagnosed during surgical LUTS treatment and summarise disease treatment and outcomes.

2. Materials and Methods

2.1. Protocol, Registration, and Ethics

The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in May 2024 (registration ID: CRD42024528863) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [7]. Ethics approval and patient consent were not required given the nature of the review (derived from previously published work).

2.2. Search Strategy

A comprehensive search across four electronic databases (MEDLINE, Embase, Web of Science, and Cochrane Database of Systematic Reviews) was conducted in May 2024. Backwards citation searching (backwards pearl growing/mining/referencing) was also performed on retrieved articles in order to identify any missed additional articles.
The Medical Subject Headings (MeSH) terms ‘transurethral resection of prostate’, ‘prostatectomy’, ‘lower urinary tract symptoms’, ‘prostatic hyperplasia’, ‘lymphoma’, and ‘leukemia’ were combined with keywords ‘transurethral resection’, ‘TURP’, ‘HOLEP’, ‘holmium laser’, ‘prostatectomy’, ‘lympho*’, and ‘leuk?emia’.
The search was limited to the English language and human species.
There were no limitations placed on the year of publication.
The complete final search strategy is provided (Figure S1).

2.3. Eligibility Criteria

Articles were included if:
  • They reported on lymphoma of the prostate diagnosed on TURP, simple prostatectomy, or holmium laser enucleation of the prostate (HoLEP) performed for LUTS or AUR;
  • They included sufficient clinical information to answer the review aims;
  • Patients were aged over 18 years;
  • The full text was available in English.
Articles were excluded if:
  • Patients already had a known diagnosis of lymphoma;
  • There was a pre-existing clinical suspicion of lymphoma based on the patient presentation;
  • Diagnosis was made on prostatic biopsy;
  • TURP, simple prostatectomy, or HoLEP were performed for indications other than LUTS or AUR;
  • They were in the form of grey literature, conference abstracts, or letters to the editor.

2.4. Article Selection

All identified citations following the search were collated and uploaded onto Covidence (Veritas Health Innovation, Melbourne, Australia) and duplicates removed. Title and abstract screening was then performed by two independent reviewers (J.C. and S.M.A.). The full texts were then reviewed in detail, with those not fitting eligibility criteria excluded. All disagreements were resolved by a third reviewer (D.W.).

2.5. Data Extraction

Data extraction was performed by two independent reviewers (J.C. and S.M.A.) and collated in an Excel spreadsheet (Microsoft Corporation, Redmond, WA, USA). Variables included patient age, presenting symptoms, examination findings such as DRE and presence of lymphadenopathy, investigations such as PSA results and prostate volume on ultrasound, type of lymphoma and histopathological findings, treatment, follow-up, and patient outcomes. Data not included in individual articles were recorded as ’not specified’.

2.6. Assessment of Methodological Quality

All articles meeting eligibility criteria were case reports. Therefore, the methodological quality of included articles was assessed with a modified tool proposed by Murad et al. [8]. The original tool comprises a total of eight questions from four domains (Table S1). Two questions relating to drug reactions were removed as they were irrelevant. The methodological quality of article was rated as high, intermediate, or low. High quality was defined as a ‘yes’ answer to four or more of the included questions, intermediate quality as a ‘yes’ answer to three questions, and low quality was a ‘yes’ answer to less than three questions.

2.7. Data Synthesis

Given all included studies were case reports, data were reported through summative statistics with a narrative synthesis approach. This summary of data is reported in Table 1.

3. Results

3.1. Article Selection

The electronic search resulted in a total of 3225 studies as follows: MEDLINE (310), Embase (1421), Cochrane Database of Systematic Reviews (2), Web of Science (1490), and backwards citation searching (2). After 617 duplicates were removed, 2608 titles and abstracts were screened, of which 52 full texts were reviewed. A total of 28 articles were excluded due to meeting exclusion criteria as detailed in Figure 1. Specifically, a large series of 62 cases by Bostwick et al. [4] was excluded as numerous cases were not incidental or were diagnosed on biopsy; furthermore, individual patient data were not available and clinical information was lacking, as the series was presented only as an overall summary of all cases.
In total, 24 articles were included, with publication years ranging from 1984 to 2023 [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32]. These were all case reports, compromising a total of 25 patient cases. All articles were deemed to be of high overall methodological quality (Table S1). A condensed summary of all cases and clinical information is presented in Table 2, with complete details provided in Table S2.

3.2. Patient Demographics and Clinical Presentation

The age range of patients was 23 to 84 years, with a median (interquartile range [IQR]) age of 67 (61–73).
All 25 patients reported LUTS as their primary complaint. In the 14 articles that reported symptom duration, the median duration of LUTS prior to diagnosis was 17 months (IQR 4–44 months). Haematuria was the next most common symptom, reported in eight patients. Three patients had undergone a previous TURP. One patient experienced fevers of unknown cause as an additional symptom, but B-symptoms were not reported in any other cases.
DRE findings were reported in 15 cases. The most common DRE finding was of an enlarged prostate (nine cases), followed by a hard prostate (three cases) and a swollen/tender prostate (two cases).
Lymphadenopathy was only reported in a single patient, with axillary and inguinal nodes involved.

3.3. Investigations

Serum PSA testing was reported in 17 patients, with 10 in the normal range. In those with an elevated result, the median PSA was 8.5 ng/mL (IQR 4.5–474.9); this included an outlier of 903 ng/mL [27].
Overall, the majority of other blood and urine results were either normal or not specified. Lactate dehydrogenase (LDH) was elevated in two cases, lymphocytosis or atypical immature lymphocytes were present in two cases, and thrombocytopaenia, elevated erythrocyte sedimentation rate (ESR), and sterile pyuria were all reported in one case each.
Baseline imaging was in the form of computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). Prostatomegaly was present in 16 cases, and in the 12 cases that reported prostate volume, median prostate size was 50 cc (IQR 31–105). Aside from prostatomegaly, other described imaging findings included T2-weighted intense nodules on MRI and echogenic areas on US.
Prostate biopsy was performed in three out of seven patients who had an elevated serum PSA, with all demonstrating BPH alone.

3.4. Surgical Intervention

In the vast majority of cases, lymphoma diagnosis was made during TURP (21 cases), followed by simple prostatectomy (three cases) and HoLEP (one case).

3.5. Lymphoma Subtype

A total of 10 different subtypes of lymphoma were reported. The most common subtypes were intravascular large B-cell lymphoma (IVLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma, with six reported cases each. Table 3 summarises the treatment modalities and patient outcomes for each subtype.

3.6. Staging—Imaging

Following a diagnosis of lymphoma, further staging imaging was performed in 17 patients. Cross-sectional imaging in the form of CT (12 cases) and positron emission tomography/computed tomography (PET/CT) (six cases) were the most common modalities, followed by bone scan (two cases) and abdominal US (one case).
Extra-prostatic involvement in the form of lymphadenopathy, solid organ involvement, or bone involvement was reported in eight patients.
Lymphadenopathy was reported in five patients, with periaortic, pericaval, pre-sacral, perirectal, common iliac, mesenteric, and inguinal nodes affected.
Extra-prostatic solid organ involvement was also reported in five patients. Local involvement included the bladder, seminal vesicles, penis, and rectum, and more distant organs affected included the spleen, sigmoid colon, caecum, ileum, oesophagus, gastric wall, and adrenal gland.
Intense focal hypermetabolic bone lesions in the cranium, clavicle, scapulae, sternum, humerus, and femur were reported in a single patient [22].

3.7. Staging—Invasive

Bone marrow aspirate was the most common invasive staging procedure, occurring in ten cases. Only one patient had a positive aspirate result, demonstrating 60% atypical immature lymphocytes and a cyclin D1-positive marker [9].
Axillary lymph node aspiration and cervical node excisional biopsy were reported in one case, with both being positive for lymphoma [25]. This corresponded with physical examination and CT findings.
Lumbar puncture was performed in one patient, with cerebrospinal fluid (CSF) fluid analysis indicating no tumour involvement [30].

3.8. Management

Chemotherapy, with or without adjuvant radiotherapy, was the mainstay of treatment. Nine patients received chemotherapy alone and five in combination with adjuvant radiotherapy. Most patients underwent a regime including cyclophosphamide, daunorubicin/doxorubicin, vincristine, and prednisolone (CHOP) +/− rituximab (R-CHOP).
Two patients underwent radiotherapy alone. Radiotherapy targeted both the prostate alone as well as other affected sites.
A single patient underwent annual clinical observation in the form of flow cytometry. Three patients refused planned treatment, and five articles did not specify management.

3.9. Outcomes

Most articles reported positive outcomes, with complete remission reported in 17 cases. Remission was achieved with each form of active management. Of the 14 studies that specified remission follow-up duration, the median follow-up was 21 months (8–24).
Patient death was reported in four cases. The time to death was six, eight, and 38 months post-diagnosis and not specified in one article. In two cases, the patient refused any treatment. One patient died despite initial chemotherapy. This patient experienced systemic disease relapse following initial successful R-CHOP chemotherapy and was recommenced on further chemotherapy. They then suffered a second systemic relapse and later died of pneumonia and neutropaenia secondary to systemic treatment.
Seven cases reported improvement or resolution of obstructive LUTS following surgery. The remaining articles did not specify LUTS outcomes.

4. Discussion

Prostatic lymphoma appears to be difficult to differentiate clinically from BPH, with limited findings to suggest this diagnosis prior to histological examination. Clinical presentation often mimics BPH, with typical LUTS including hesitancy, poor stream, frequency, and AUR. DRE does not appear to provide any indication of lymphoma and lymphadenopathy was initially reported in only one case. However, in another article, cervical, axillary, and inguinal lymphadenopathy was noted only upon retrospective examination following lymphoma diagnosis [25]. Of course, a complete thorough haematological physical examination prior to surgical intervention for LUTS may be more than what is expected of urologists.
It is well known that BPH can cause an elevated PSA [33], but the relationship between lymphoma and PSA is not well established, with some case series reporting a mean PSA of only 3.5–5.3 ng/mL [4,34] but with other studies supporting a raised PSA [35]. Nerli et al. described a 73-year-old man with a raised PSA of 46.8 ng/mL, which decreased to 1.9 ng/mL following TURP [21]. Similarly, Tomaru et al. reported on a patient with an initial PSA of 903 ng/mL, which subsequently decreased to 8.6 ng/mL three months post-TURP [27]. Both these cases did not receive any treatment for lymphoma. Therefore, it is difficult to ascertain whether elevated PSA was due to BPH alone or related to lymphoma too. Clearly, the most likely cause of a persistently elevated PSA after surgical treatment of an enlarged prostate with lymphoma is a concurrent diagnosis of prostatic adenocarcinoma [36,37].
A diagnosis of prostatic lymphoma should not be definitively excluded despite previous benign histopathology. Williams et al. reported a case with two previous benign TRUS biopsies who underwent a retropubic prostatectomy six years later which demonstrated follicular lymphoma in a 350 cc specimen [29]. Similarly, another patient by Li et al. was diagnosed with MALT lymphoma on second TURP, and similar histological features were present on retrospective examination of the initial TURP specimen from seven years prior [18]. Three patients underwent needle biopsy of the prostate prior to TURP which demonstrated BPH only [11,21,25]. This reflects that prostatic biopsy is not completely sensitive, and similar to adenocarcinoma, prostatic lymphoma may also be missed on initial biopsy.
Similarly, a diagnosis of lymphoma should be considered in younger patients with symptoms of bladder outlet obstruction, especially given the low pre-test possibility of BPH. Fell et al. reported on a 23-year-old with bladder outlet obstruction but normal investigations aside from sterile pyuria and mildly elevated ESR [13]. Tuberculous prostatitis was excluded with further investigations, and mixed lymphocytic–histiocytic-type lymphoma was diagnosed on TURP.
Disease type was largely varied, with 10 different lymphoma subtypes as detailed in Table 3. This is consistent with the wide diversity of the disease in general, with over 80 subtypes described [38,39]. Treatment centred around chemoradiotherapy, with R-CHOP/CHOP being the mainstay regime of choice, and other combinations such as rituximab/cyclophosphamide/vincristine/prednisolone and chlorambucil/prednisolone less common. However, there was a wide array of different chemotherapy regimens and radiotherapy dosages utilised, ranging from four to eight cycles of chemotherapy and five to 25 fractions of radiotherapy. The use of adjuvant radiotherapy was sporadic, and the articles did not specify the indication for its use. Overall, there was no particular apparent pattern predicting the prescribed treatment, reflecting the heterogeneity of the disease and thus treatment. Similar difficulties have been described in the literature, as there is no consensus for treatment due to the rarity of disease [6,12]. This is reflected in literature exploring genitourinary lymphoma in general. A recent 2024 article by Al-Maghrabi et al. described the treatment and outcomes of 11 patients with various lymphoma subtypes of the urinary bladder, testes, spermatic cord, ureter, and prostate [40]. There was a similar degree of heterogeneity in treatment regime and outcomes, but again treatment was predominantly R-CHOP, supporting its efficacy in most genitourinary lymphomas. R-CHOP was also shown to be an effective treatment in an analysis of 195 patients with primary bladder lymphoma [41]. This analysis also suggested that patients with low-grade tumours appear to respond well to local therapy such as transurethral resection. Several articles included in our review described patients who successfully demonstrated cancer remission despite no further documented specified treatment; perhaps local resection of prostatic lymphoma, in the form of TURP alone, may be a valid treatment in select cases. Overall, the particulars of treatment are beyond the scope of practice for urologists, but prompt referral to oncology or haematology is warranted. Most patients had good outcomes with treatment, with only four total deaths including two occurring in patients refusing treatment. This demonstrates the often indolent and curable nature of lymphoma [42,43], particularly with early diagnosis.
A limitation of this review is the diverse nature of case reports and the subsequent reporting inconsistencies and biases both within and between articles. Several papers had missing datapoints which predisposes to inaccuracies if you were to pool data, but these have been highlighted in this systematic review. Missing data classified as ‘not specified’ may not have been available or reported. For example, several articles did not specify if treatment was implemented (including if no treatment was given) but did report on patient outcomes. Furthermore, aggregation of case reports is inherently biased given not all cases are published. Therefore, results derived from this review are not expected to be an exact reflection of clinical practice but rather serve to enhance our knowledge of a rare subject matter [44].

5. Conclusions

In conclusion, this systematic review summarises the features and management of incidentally diagnosed prostatic lymphoma. It is difficult to diagnose clinically due to its similar presentation to BPH. Although rare, prostatic lymphoma may need to be considered as a diagnosis in patients with an atypical presentation of BPH. Prompt referral to haematology or oncology is warranted and prognosis is often favourable with systemic treatment. Additional cases in the literature are required to further understand this uncommon entity but this review provides a broad overview of the disease.

Supplementary Materials

The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/siuj6020028/s1, Figure S1: Complete final search strategy; Table S1: Methodological quality assessment; Table S2: Detailed summary of 25 articles.

Author Contributions

Conceptualization, J.C., N.P., J.I., D.B., and D.W.; methodology, J.C., S.M.A., N.P., J.I., D.B., and D.W.; writing—original draft preparation, J.C. and S.M.A.; writing—review and editing, J.C., S.M.A., N.P., J.I., D.B., and D.W.; supervision, J.I., D.B., and D.W. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Data Availability Statement

The data supporting the findings of this study are available within the article and/or its Supplementary Material.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Sarris, A.; Dimopoulos, M.; Pugh, W.; Cabanillas, F. Primary lymphoma of the prostate: Good outcome with doxorubicin-based combination chemotherapy. J. Urol. 1995, 153, 1852–1854. [Google Scholar] [CrossRef] [PubMed]
  2. Warrick, J.I.; Owens, S.R.; Tomlins, S.A. Diffuse large B-cell lymphoma of the prostate. Arch. Pathol. Lab. Med. 2014, 138, 1286–1289. [Google Scholar] [CrossRef] [PubMed]
  3. Chu, P.G.; Huang, Q.; Weiss, L.M. Incidental and Concurrent Malignant Lymphomas Discovered at the Time of Prostatectomy and Prostate Biopsy: A Study of 29 Cases. Am. J. Surg. Pathol. 2005, 29, 693–699. [Google Scholar] [CrossRef] [PubMed]
  4. Bostwick, D.G.; Iczkowski, K.A.; Amin, M.B.; Discigil, G.; Osborne, B. Malignant lymphoma involving the prostate: Report of 62 cases. Cancer 1998, 83, 732–738. [Google Scholar] [CrossRef]
  5. Bostwick, D.G.; Mann, R.B. Malignant lymphomas involving the prostate. A study of 13 cases. Cancer 1985, 56, 2932–2938. [Google Scholar] [CrossRef]
  6. Hu, S.; Wang, Y.; Yang, L.; Yi, L.; Nian, Y. Primary non-Hodgkin’s lymphoma of the prostate with intractable hematuria: A case report and review of the literature. Oncol. Lett. 2015, 9, 1187–1190. [Google Scholar] [CrossRef]
  7. Moher, D.; Shamseer, L.; Clarke, M.; Ghersi, D.; Liberati, A.; Petticrew, M.; Shekelle, P.; Stewart, L.A. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev. 2015, 4, 1. [Google Scholar] [CrossRef]
  8. Murad, M.H.; Sultan, S.; Haffar, S.; Bazerbachi, F. Methodological quality and synthesis of case series and case reports. BMJ Evid. Based Med. 2018, 23, 60–63. [Google Scholar] [CrossRef]
  9. Atay, M.H.; Kelkitli, E.; Alici, O.; Cilingir, F.; Turgut, M. Presentation of mantle cell lymphoma with symptoms of prostatism. Pol. Arch. Med. Wewn. 2013, 123, 643–644. [Google Scholar] [CrossRef]
  10. Cos, L.R.; Rashid, H.A. Primary non-Hodgkin lymphoma of prostate presenting as benign prostatic hyperplasia. Urology 1984, 23, 176–179. [Google Scholar] [CrossRef]
  11. Csomor, J.; Kaszas, I.; Kollar, B.; Pajor, L.; Egyhazi, Z.; Fekete, S.; Egyed, M.; Timar, B. Prolonged survival using anti-CD20 combined chemotherapy in primary prostatic intravascular large B-cell lymphoma. Pathol. Oncol. Res. 2008, 14, 281–284. [Google Scholar] [CrossRef] [PubMed]
  12. Ezekwudo, D.E.; Ogunleye, F.; Gbadamosi, B.; Blankenship, L.M.; Kinoyan, M.; Krauss, D.; Hollander, M.; Haberichter, K.; Jaiyesimi, I. Primary Extranodal Diffuse Large B-Cell Lymphoma of the Prostate: A Case Report. Case Rep. Oncol. 2017, 10, 199–204. [Google Scholar] [CrossRef] [PubMed]
  13. Fell, P.; O’Connor, M.; Smith, J.M. Primary lymphoma of prostate presenting as bladder outflow obstruction. Urology 1987, 29, 555–556. [Google Scholar] [CrossRef] [PubMed]
  14. Gu, L.; Li, M.; Tong, G.; Wei, W.; Fan, Y.; Zhao, Y. Prostate primary intravascular large B-cell lymphoma: A case report. Urol. Case Rep. 2022, 45, 102276. [Google Scholar] [CrossRef]
  15. Hashemzadeh, S.; Farrokhi, F.; Hozhabrossadaty, A.; Ghafarzadegan, K.; Ashraf, H. A case of recurrent hematuria in primary prostatic low grade mucosa associated lymphoid tissue. J. Nephropathol. 2017, 6, 49–52. [Google Scholar] [CrossRef]
  16. Jhavar, S.; Agarwal, J.P.; Naresh, K.N.; Shrivastava, S.K.; Borges, A.M.; Dinshaw, K.A. Primary extranodal mucosa associated lymphoid tissue (MALT) lymphoma of the prostate. Leuk. Lymphoma 2001, 41, 445–449. [Google Scholar] [CrossRef]
  17. Karademir, B.; Kisa, E.; Ozbilen, M.H.; Bildirici, C.; Karabacakoglu, B.; Suelozgen, T.; Ilbey, Y.O.; Kucuk, U.; Olgun, A. Unexpected hematologic malignancies after prostatectomy: Case report and literature review. Urologia 2021, 88, 382–385. [Google Scholar] [CrossRef]
  18. Li, C.; Hibino, M.; Komatsu, H.; Sakuma, H.; Sakakura, T.; Ueda, R.; Eimoto, T.; Inagaki, H. Primary mucosa-associated lymphoid tissue lymphoma of the prostate: Tumor relapse 7 years after local therapy. Pathol. Int. 2008, 58, 191–195. [Google Scholar] [CrossRef]
  19. Mansbridge, M.M.; Parker, J.R.; Francisco, S.; McClintock, S.T. Diagnosis of monoclonal B cell lymphocytosis (MBL) through transurethral resection of prostate for obstructive lower urinary tract symptoms. Urol. Case Rep. 2020, 29, 101086. [Google Scholar] [CrossRef]
  20. Martin, O.D.; Wadskier, L.A.; Quiroz, Y.; Bravo, H.P.; Cacciamani, G.; Umana, P.; Medina, L. Primary non-Hodgkin lymphoma of the prostate: A case report. Ecancermedicalscience 2017, 11, 789. [Google Scholar] [CrossRef]
  21. Nerli, R.B.; Sanikop, A.; Sharma, M.; Patel, P.; Kangale, R.; Patil, S.; Ghagane, S.C.; Hiremath, M.B.; Dixit, N.S. Primary Non-Hodgkin Lymphoma of Prostate: A Case Report. Indian. J. Surg. Oncol. 2020, 11, 274–277. [Google Scholar] [CrossRef] [PubMed]
  22. Ochirjav, E.; Tsedenbal, B.; Enkhjargal, M.; Mendbayar, E.; Sharkhuu, E. Hematolymphoid tumor of prostate: Diffuse large B cell lymphoma case report. Urol. Case Rep. 2023, 50, 102497. [Google Scholar] [CrossRef] [PubMed]
  23. Ozsan, N.; Sarsik, B.; Yilmaz, A.F.; Simsir, A.; Donmez, A. Intravascular large B-cell lymphoma diagnosed on prostate biopsy: A case report. Turk. J. Haematol. 2014, 31, 403–407. [Google Scholar] [CrossRef] [PubMed]
  24. Rallabandi, H.B.; Thirukovela, J.; Swain, M.; Meeramira, D.; Gowrishankar, S. Intravascular large B cell lymphoma of prostate, a rare entity. Indian. J. Pathol. Microbiol. 2021, 64, 575–578. [Google Scholar] [CrossRef]
  25. Singh, I.; Joshi, M.; Agarwal, S.; Singh, U.R.; Saran, R. Extra-nodal small cell lymphocytic lymphoma of prostate: An unusual cause of lower urinary tract symptoms. Urology 2008, 71, 547 e547–e549. [Google Scholar] [CrossRef]
  26. Terada, T. Primary follicular lymphoma of the prostate. Case Rep. Clin. Pathol. 2016, 3, 24–28. [Google Scholar] [CrossRef]
  27. Tomaru, U.; Ishikura, H.; Kon, S.; Kanda, M.; Harada, H.; Yoshiki, T. Primary lymphoma of the prostate with features of low grade B-cell lymphoma of mucosa associated lymphoid tissue: A rare cause of urinary obstruction. J. Urol. 1999, 162, 496–497. [Google Scholar] [CrossRef]
  28. Tomikawa, S.; Okumura, H.; Yoshida, T.; Mochizuki, H.; Miwa, A.; Takayanagi, K.; Yoshino, T.; Ohtake, S.; Fujimura, M.; Nakamura, S.; et al. Primary prostatic lymphoma of mucosa-associated lymphoid tissue. Intern. Med. 1998, 37, 628–630. [Google Scholar] [CrossRef]
  29. Williams, I.S.C.; Roberts-Thomson, S.; Lawrentschuk, N.; Sathianathen, N.J. Primary follicular lymphoma of an extraordinarily large prostate: A case report and review of the literature. Urol. Case Rep. 2023, 50, 102530. [Google Scholar] [CrossRef]
  30. Wu, Y.F.; Li, X.; Ma, J.; Ma, D.Y.; Zeng, X.M.; Yu, Q.W.; Chen, W.G. Primary prostate Burkitt’s lymphoma resected with holmium laser enucleation of the prostate: A rare case report. World J. Clin. Cases 2023, 11, 4406–4411. [Google Scholar] [CrossRef]
  31. Xu, M.; Yang, Q.; Li, M.; Geng, W.; Huang, W.; Chen, Y. Prostate involvement by intravascular large B-cell lymphoma: A case report with literature review. Int. J. Surg. Pathol. 2011, 19, 544–547. [Google Scholar] [CrossRef] [PubMed]
  32. Zhu, F.; Pan, H.; Xiao, Y.; Li, Q.; Liu, T.; Liu, X.; Wu, G.; Li, J.; Zhang, L. A case report of primary prostate intravascular large B cell lymphoma presenting as prostatic hyperplasia. Medicine 2019, 98, e18384. [Google Scholar] [CrossRef] [PubMed]
  33. Roehrborn, C.G.; Boyle, P.; Gould, A.L.; Waldstreicher, J. Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology 1999, 53, 581–589. [Google Scholar] [CrossRef]
  34. Péricart, S.; Syrykh, C.; Amara, N.; Franchet, C.; Malavaud, B.; Gaulard, P.; Girard, J.P.; Ysebaert, L.; Laurent, C.; Brousset, P. Exclusive B-cell phenotype of primary prostatic lymphomas: A potential role of chronic prostatitis. Histopathology 2020, 76, 767–773. [Google Scholar] [CrossRef]
  35. Oosterheert, J.J.; Budel, L.M.; Vos, P.; Wittebol, S. High levels of serum prostate-specific antigen due to PSA producing follicular non-Hodgkin’s lymphoma. Eur. J. Haematol. 2007, 79, 155–158. [Google Scholar] [CrossRef]
  36. Ballario, R.; Beltrami, P.; Cavalleri, S.; Ruggera, L.; Zorzi, M.G.; Artibani, W. An unusual pathological finding of chronic lymphocitic leukemia and adenocarcinoma of the prostate after transurethral resection for complete urinary retention: Case report. BMC Cancer 2004, 4, 95. [Google Scholar] [CrossRef]
  37. Dhillon, J.; Pow-Sang, J.M.; Poch, M.A.; Zhang, L. Concurrence of prostatic adenocarcinoma and lymphoma: Clinical and pathological characteristics–Single institutional experience. J. Clin. Oncol. 2015, 33, e16101. [Google Scholar] [CrossRef]
  38. de Leval, L.; Jaffe, E.S. Lymphoma Classification. Cancer J. 2020, 26, 176–185. [Google Scholar] [CrossRef]
  39. Sapkota, S.; Shaikh, H. Non-Hodgkin Lymphoma. In StatPearls; StatPearls Publishing Copyright © 2024; StatPearls Publishing LLC.: Treasure Island, FL, USA, 2024; Disclosure: Hira Shaikh declares no relevant financial relationships with ineligible companies. [Google Scholar]
  40. Al-Maghrabi, H.; Al-Maghrabi, J. Non-Hodgkin’s primary lymphoma involving the genitourinary tract: Histopathological experience from two tertiary hospitals, Western region, Saudi Arabia. Am. J. Clin. Exp. Urol. 2024, 12, 288–295. [Google Scholar] [CrossRef]
  41. Sellman, D.P.; Simpson, W.G.; Klaassen, Z.; Jen, R.P.; DiBianco, J.M.; Reinstatler, L.; Li, Q.; Madi, R.; Terris, M.K. Characterization and outcomes of local treatment for primary bladder lymphoma: A population-based cohort analysis. Urol. Ann. 2018, 10, 249–253. [Google Scholar] [CrossRef]
  42. Horning Sandra, J.; Rosenberg Saul, A. The Natural History of Initially Untreated Low-Grade Non-Hodgkin’s Lymphomas. New Engl. J. Med. 1984, 311, 1471–1475. [Google Scholar] [CrossRef]
  43. Zinzani, P.L. Lymphoma: Diagnosis, staging, natural history, and treatment strategies. Semin. Oncol. 2005, 32, 4–10. [Google Scholar] [CrossRef]
  44. Jackson, D.; Daly, J.; Saltman, D.C. Aggregating case reports: A way for the future of evidence-based health care? Clin. Case Rep. 2014, 2, 23–24. [Google Scholar] [CrossRef] [PubMed]
Siuj 06 00028 g001
Figure 1. Study search strategy: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
Figure 1. Study search strategy: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
Siuj 06 00028 g001
Table 1. Patient demographics, presentation, pathology, and outcomes.
Table 1. Patient demographics, presentation, pathology, and outcomes.
Total Cases n = 25Median (IQR)/n (%)
Baseline demographics
Age (years)67 (61–73)
History
LUTS duration (months) [n = 14]17 (4–44)
AUR 8 (32)
Haematuria5 (20)
Previous TURP 3 (12)
Fever 1 (4)
Physical examination
DRE (including multiple findings per case)
          Enlarged 9 (36)
          Hard3 (12)
          Swollen/tender2 (8)
          Normal3 (12)
          Not specified10 (40)
Lymphadenopathy1 (4)
Investigations
PSA
          Normal10 (40)
          Elevated7 (28)
          Not specified 8 (32)
PSA level (ng/mL) [n = 12]2.3 (1.6–6.6)
PSA level in elevated subgroup (ng/mL) [n = 5]8.5 (4.5–474.9)
Abnormal blood/urine tests
          Elevated lactate dehydrogenase2 (8)
          Lymphocytosis/atypical lymphocytes2 (8)
          Thrombocytopaenia 1 (4)
          Elevated erythrocyte sedimentation rate1 (4)
          Sterile pyuria1 (4)
Imaging (CT/US/MRI)
          Prostatomegaly 16 (64)
          Estimated prostate volume (cc) [n = 12]51 (31–105)
Surgical intervention
TURP21 (84)
Open prostatectomy3 (12)
HoLEP1 (4)
Lymphoma subtype
Intravascular large B-cell lymphoma6 (24)
Mucosa-associated lymphoid tissue lymphoma6 (24)
Follicular lymphoma3 (12)
Chronic lymphocytic leukaemia 2 (8)
Diffuse large B-cell lymphoma 2 (8)
Mantle cell lymphoma 2 (8)
Burkitt lymphoma1 (4)
Mixed lymphocytic–histiocytic-type lymphoma1 (4)
Non-Hodgkin lymphoma 1 (4)
Small-cell lymphocytic lymphoma 1 (4)
Staging (imaging)
Imaging modality (including multiple modalities per case)
          CT12 (48)
          PET/CT6 (24)
          Bone scan2 (8)
          Abdominal US1 (4)
          Not specified8 (32)
Lymphadenopathy5 (20)
Extra-prostatic organ involvement5 (20)
Bone involvement1 (4)
Staging (invasive)
Bone marrow aspirate 10 (40)
Lymph node aspiration/biopsy1 (4)
Lumbar puncture 1 (4)
Management
Chemotherapy alone9 (36)
Chemotherapy + adjuvant radiotherapy5 (20)
Radiotherapy alone2 (8)
Observation1 (4)
Patient refusal3 (12)
Not specified 5 (20)
IQR, interquartile range; AUR, acute urinary retention; HoLEP, holmium laser enucleation of prostate; PET/CT; positron emission tomography/computed tomography; US, ultrasound.
Table 2. Summary of 25 included articles.
Table 2. Summary of 25 included articles.
TitleAuthorYearCountry Number of CasesLymphoma SubtypeAge (Years)LUTS Duration (Months)AURDRESerum PSA (ng/mL)Prostate Volume (cc)InterventionStaging Imaging Extraprostatic Involvement on ImagingManagementOutcome
“Presentation of mantle cell lymphoma with symptoms of prostatism” [9]Atay 2013Turkey1MCL712NoNot specifiedNot specifiedNot specified TURPCTYesChemotherapy—rituximab/cyclophosphamide/daunorubicin/vincristine/prednisolone (R-CHOP) ×4 cycles;
radiotherapy—residual lymph nodes 		Remission—follow-up duration not specified
“Primary non-Hodgkin lymphoma of prostate presenting as benign prostatic hyperplasia” [10]Cos1984USA1NHL623NoEnlarged, symmetrical, rubberyNot specifiedNot specified TURPCT and bone scanYesChemotherapy—chlorambucil/prednisoloneNot specified
“Prolonged survival using anti-CD20 combined chemotherapy in primary prostatic intravascular large B-cell lymphoma” [11]Csomor 2008Hungary1IVLBCL73Not specifiedNoNot specifiedElevated 51TURPCT and bone scanNoChemotherapy—R-CHOP ×8 cyclesInitial remission; first systemic relapse eight months later, retreated 25 months post-initial diagnosis; second systemic relapse five months later—death from pneumonia
“Primary Extranodal Diffuse Large B-Cell Lymphoma of the Prostate: A Case Report” [12]Ezekwudo 2017USA1DLBCL54Not specifiedNoFirm, enlarged, no nodularityNormal (2.0)Normal—not further specified TURPCT and PET/CTYesChemotherapy—R-CHOP;
radiotherapy—not further specified		Remission on PET—two years follow-up
“Primary lymphoma of prostate presenting as bladder outflow obstruction” [13]Fell1987Ireland1Mixed lymphocytic–histiocytic-type lymphoma2310NoNormalNot specifiedNot specified TURPNot specified Not specified Radiotherapy—five fractions to prostate gland Remission—two years follow-up
“Prostate primary intravascular large B-cell lymphoma: A case report” [14]Gu2022China1IVLBCL7660NoTough and hard, disappearing central sulcus, no nodularity or tendernessNormal (2.1)109TURPNot specified Not specified Patient refusal of treatmentDeath—six months follow-up
“A case of recurrent hematuria in primary prostatic low grade mucosa associated lymphoid tissue” [15]Hashemzadeh 2017Iran1MALT lymphoma636YesEnlarged, no nodularityNot specifiedNormal—not further specified TURP x2CTNoNot specifiedRemission—eight months follow-up
“Primary extranodal mucosa associated lymphoid tissue (MALT) lymphoma of the prostate” [16]Jhavar 2001India1MALT lymphoma674NoMildly enlarged, smooth and firm with diffuse marginsNormalProstatomegaly—not further specified TURPCTNoRadiotherapy—4400 centigray, 22 fractionsRemission—two years follow-up
“Unexpected hematologic malignancies after prostatectomy: Case report and literature review” [17]Karademir 2021Turkey2Case 1: CLL6072NoGrade 2 prostateNormal (1.0)154Open suprapubic prostatectomy (Freyer’s)CTYesHaematology follow-up—not further specifiedNot specified
Case 2: MCL6248NoGrade 1 prostateNormal (1.9)52TURPCTNoChemotherapy—R-CHOP ×8 cyclesRemission—five years follow-up
“Primary mucosa-associated lymphoid tissue lymphoma of the prostate: tumor relapse 7 years after local therapy” [18]Li2008Japan1MALT lymphoma79Not specifiedYesElastic hard mass in right lobeNormal Normal—not further specified TURP x2Not specifiedNot specifiedChemotherapy—R-CHOP;
radiotherapy—not further specified		Remission—two years follow-up
“Diagnosis of monoclonal B cell lymphocytosis (MBL) through transurethral resection of prostate for obstructive lower urinary tract symptoms” [19]Mansbridge 2020Australia1CLL73Not specifiedNoMildly enlarged, smooth Normal (0.9)31TURPCTNoClinical observation—yearly flow cytometryNot specified
“Primary non-Hodgkin lymphoma of the prostate: A case report” [20]Martin2017Colombia1MALT lymphoma6836NoRegular size, no nodularity, normal consistency, no massesNormal (1.4)50TURPCTNoChemotherapy—rituximab/cyclophosphamide/vincristine/prednisolone (R-CVP) ×6 cyclesRemission and resolution of LUTS—five years follow-up
“Primary Non-Hodgkin Lymphoma of Prostate: a Case Report” [21]Nerli2020India1Follicular NHL7336YesNot specifiedElevated (46.8)147TURPCTNoPatient refusal of treatmentNot specified
“Hematolymphoid tumor of prostate: Diffuse large B cell lymphoma case report” [22]Ochirjav2023Mongolia1DLBCL676YesNot specifiedNot specifiedEnlarged—not further specified TURPPET/CTYesNot specifiedRemission and improvement in LUTS—follow-up duration not specified
“Intravascular Large B-Cell Lymphoma Diagnosed on Prostate Biopsy: A Case Report” [23]Özsan 2014Turkey1IVLBCL65Not specifiedNoNot specifiedNormal (2.4)31TURPPET/CT
and abdominal US		YesPatient refusal of treatment Death—eight months follow-up
“Intravascular large B cell lymphoma of prostate, a rare entity” [24]Rallabandi 2021India1IVLBCL760.5YesGrade 2 prostateNormalNormal—not further specified TURPPET/CTNoChemotherapy—not further specifiedDeath—follow-up duration not specified
“Extra-nodal Small Cell Lymphocytic Lymphoma of Prostate: An Unusual Cause of Lower Urinary Tract Symptoms” [25]Singh2008India1SCLL60Not specifiedYesEnlargedElevated (8.5)30TURPCTYesOncology follow-up—not further specified Remission and decreased PSA—six months follow-up
“Primary follicular lymphoma of the prostate” [26]Terada2016Japan1Follicular lymphoma68Not specifiedNoSwollen, elastic, hardElevated (4.6)Normal—not further specified TURPNot specifiedNot specifiedChemotherapy—R-CHOP;
radiotherapy—local radiation, 40 gray		Remission and decreased PSA—five months follow-up
“Primary lymphoma of the prostate with features of low grade B-cell lymphoma of mucosa associated lymphoid tissue: A rare cause of urinary obstruction” [27]Tomaru1999Japan1MALT lymphoma84Not specifiedYesFirm, moderately enlarged with tendernessElevated (903)Normal—not further specified TURPNot specifiedNot specifiedNot specifiedRemission and decreased PSA—two years follow-up
“Primary prostatic lymphoma of mucosa-associated lymphoid tissue” [28]Tomikawa 1998Japan1MALT lymphoma5024NoNot specifiedNot specifiedProstatomegaly—not further specified TURPNot specifiedNot specifiedChemotherapy—CHOP ×6 cyclesRemission—eighteen months follow-up
“Primary follicular lymphoma of an extraordinarily large prostate: A case report and review of the literature” [29]Williams 2023Australia1Follicular lymphoma 74Not specifiedNoNot specifiedNot specifiedMassive prostatomegaly—not further specified Millen retropubic prostatectomy Not specifiedNot specifiedChemotherapy—rituximab/cyclophosphamide then R-CHOP/intrathecal methotrexateRemission—six months follow-up
“Primary prostate Burkitt’s lymphoma resected with holmium laser enucleation of the prostate: A rare case report” [30]Wu2023China1Burkitt lymphoma57Not specifiedYesNot specifiedElevated (4.3)36HoLEPPET/CTYesChemotherapy—pre-treatment regime then rituximab/vinpocetine/methotrexate/doxorubicin/cyclophosphamide/dexamethasone x4 cyclesRemission—follow-up duration not specified
“Prostate involvement by intravascular large B-cell lymphoma: a case report with literature review” [31]Xu 2011China1IVLBCL65Not specifiedNoNot specifiedElevated 29Transvesical prostatectomyNot specifiedNot specifiedChemotherapy—CHOP ×5 cyclesRemission—thirteen months follow-up
“A case report of primary prostate intravascular large B cell lymphoma presenting as prostatic hyperplasia” [32]Zhu 2019China1IVLBCL7148NoNot specifiedNot specified100TURPPET/CTNoChemotherapy—R-CHOP ×4 cycles then further unspecified chemotherapy;
radiotherapy—prostate 45 gray, 25 fractions		Remission and improvement in LUTS—one year follow-up
AUR, acute urinary retention; CLL, chronic lymphocytic leukaemia; CT, computed tomography; DLBCL, diffuse large B-cell lymphoma; DRE, digital rectal examination; HoLEP, holmium laser enucleation of prostate; IVLBCL, intravascular large B-cell lymphoma; LUTS, lower urinary tract symptoms; MALT, mucosa-associated lymphoid tissue; MCL, mantle cell lymphoma; NHL, non-Hodgkin’s lymphoma; PET, positron emission tomography; PSA, prostate-specific antigen; R-CHOP, rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone; SCLL, small-cell lymphocytic lymphoma; TURP, transurethral resection of prostate; US, ultrasound.
Table 3. Treatment and outcomes by lymphoma subtype.
Table 3. Treatment and outcomes by lymphoma subtype.
Lymphoma SubtypeTreatmentOutcome
Intravascular large B-cell lymphoma (n = 6)1. Chemotherapy (R-CHOP)1. Death after initial remission (30 months post-initial diagnosis)
2. No treatment (patient refusal)2. Death (six months follow-up)
3. No treatment (patient refusal)3. Death (eight months follow-up)
4. Chemotherapy (not specified)4. Death (follow-up duration not specified)
5. Chemotherapy (CHOP)5. Remission (13 months follow-up)
6. Chemotherapy (R-CHOP) with adjuvant chemotherapy 6. Remission (one year follow-up)
Mucosa-associated lymphoid tissue lymphoma (n = 6)1. Not specified1. Remission (eight months follow up)
2. Radiotherapy (22 fractions)2. Remission (two years follow-up)
3. Chemotherapy (R-CHOP) with adjuvant radiotherapy3. Remission (two years follow-up)
4. Chemotherapy (R-CVP)4. Remission (five years follow-up)
5. Not specified5. Remission (two years follow-up)
6. Chemotherapy (CHOP)6. Remission (18 months follow-up)
Follicular lymphoma
(n = 3)		1. No treatment (patient refusal)1. Not specified
2. Chemotherapy (R-CHOP) with adjuvant radiotherapy2. Remission (five months follow-up)
3. Chemotherapy (R-CHOP)3. Remission (six months follow-up)
Chronic lymphocytic leukaemia (n = 2)1. Haematology follow-up (not specified) 1. Not specified
2. Clinical observation (annual flow cytometry)2. Not specified
Diffuse large B-cell lymphoma (n = 2)1. Chemotherapy (R-CHOP) with adjuvant radiotherapy1. Remission (two years follow-up)
2. Not specified2. Remission (follow-up duration not specified)
Mantle cell lymphoma
(n = 2)		1. Chemotherapy (R-CHOP) with adjuvant radiotherapy 1. Remission (follow-up duration not specified)
2. Chemotherapy (R-CHOP)2. Remission (five years follow-up)
Burkitt lymphoma (n = 1)1. Chemotherapy (R-CHOP)1. Remission (follow-up duration not specified)
Mixed lymphocytic–histiocytic-type lymphoma (n = 1)1. Radiotherapy (five fractions)1. Remission (two years follow-up)
Non-Hodgkin lymphoma (n = 1)1. Chemotherapy (chlorambucil/prednisolone)1. Not specified
Small-cell lymphocytic lymphoma (n = 1)1. Oncology follow-up (not specified)1. Remission (six months follow-up)
R-CHOP, rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone; CHOP, cyclophosphamide/doxorubicin/vincristine/prednisolone; R-CVP, rituximab/cyclophosphamide/vincristine/prednisolone.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Cheng, J.; Alwis, S.M.; Papa, N.; Ischia, J.; Bolton, D.; Woon, D. Features and Management of Incidental Prostatic Lymphoma Obtained in Lower Urinary Tract Symptoms Surgery: A Systematic Review. Soc. Int. Urol. J. 2025, 6, 28. https://doi.org/10.3390/siuj6020028

AMA Style

Cheng J, Alwis SM, Papa N, Ischia J, Bolton D, Woon D. Features and Management of Incidental Prostatic Lymphoma Obtained in Lower Urinary Tract Symptoms Surgery: A Systematic Review. Société Internationale d’Urologie Journal. 2025; 6(2):28. https://doi.org/10.3390/siuj6020028

Chicago/Turabian Style

Cheng, Jeremy, Samith Minu Alwis, Nathan Papa, Joseph Ischia, Damien Bolton, and Dixon Woon. 2025. "Features and Management of Incidental Prostatic Lymphoma Obtained in Lower Urinary Tract Symptoms Surgery: A Systematic Review" Société Internationale d’Urologie Journal 6, no. 2: 28. https://doi.org/10.3390/siuj6020028

APA Style

Cheng, J., Alwis, S. M., Papa, N., Ischia, J., Bolton, D., & Woon, D. (2025). Features and Management of Incidental Prostatic Lymphoma Obtained in Lower Urinary Tract Symptoms Surgery: A Systematic Review. Société Internationale d’Urologie Journal, 6(2), 28. https://doi.org/10.3390/siuj6020028

Article Metrics

Back to TopTop