A case of prostatic abscess with malignant lymphoma involving the prostate

Abstract

Here, we report a case of prostatic abscess probably due to malignant lymphoma of the prostate. An 82-year-old man was referred to our hospital with chief complaints of urinary frequency and discomfort on urination. Antibiotics were prescribed, but the symptoms remained and intermittent fever appeared. The patient was diagnosed with prostatic abscess by computed tomography (CT). Digital rectal examination (DRE) revealed soft prostate, and thick pus was milked out from the extrameatus by prostatic massage. For drainage, we performed transurethral resection of the prostate (TURP). Drainage by TURP was successful as CT clearly showed reduction of prostatic abscess after the operation. Nevertheless, intermittent fever did not improve and the patient's general condition deteriorated. The day before the patient died, histopathological analysis showed prostatic abscess probably due to malignant lymphoma of the prostate and incidental adenocarcinoma. This is the first report of prostatic abscess with malignant lymphoma involving the prostate.

Figure 1

(a) CT revealed low-attenuating, round, well-demarcated fluid collection with calcification at the dorsal site of the prostate (arrows) and some lymph nodes were swollen near the prostate (arrowhead). The cystic lesion volume was about 50 mL. (b) CT revealed clear reduction of fluid collection at the dorsal site of the prostate.

Figure 2

Histopathological examination. (a, b) Hematoxylin-eosin-stained section showing extensive infiltration of large B cells ((a) ×200, (b) ×400). (c, d) Immunohistochemistry panels showing positivity for CD20 ((c) ×200) and negativity for CD3 ((d) ×200). (e) Hematoxylin-eosin-stained section showing intercellular infiltration of inflammatory cells (×100). (f) Hematoxylin-eosin-stained section showing adenocarcinoma (×200). The Gleason score of the prostate cancer was 3 + 4.