Lymphomas of the Urinary Bladder: A Review of the Literature

Background: Lymphoma of the urinary bladder is a very rare lesion in view of this its manifestation, diagnosis, and treatment may not be known by some practitioners.

Aims: To review and update the literature on lymphoma of the urinary bladder

Methods: Internet data search bases including: Pub Med, Google, Google Scholar, Yahoo, and Bing were used to identify documented literature from case reports and cases series and studies on lymphoma of the urinary bladder in order to define the lesion and to document its presentation, diagnosis and treatment.

Results / Literature Review: Lymphoma of the urinary bladder can be either (a) primary lymphoma of the urinary bladder which is a rare lymphoma originating in the urinary bladder with no known lymphoma elsewhere or (b) secondary lymphoma of the urinary bladder which is much more common and secondary lymphoma is associated with a primary lymphoma that has originated in an extra vesical site.

Lymphomas of the urinary bladder do have a female predominance, and majority of cases of lymphoma of the urinary bladder do occur in middle age women. Secondary involvement of the urinary bladder does occur in 10% to 25% of leukemias / lymphomas and they tend to occur in advanced stage systemic lymphoma. Less than 100 cases of lymphoma of the urinary bladder have been reported so far. MALT lymphoma is the most common sub-type of lymphoma in the urinary bladder and this typically tends to affect adults who are more than 60 years old and 75% are female. It has been reported that diffuse large B cell lymphoma is also common, and they may arise from transformation of MALT.

Lymphoma of the urinary bladder manifests with visible haematuria, dysuria, urinary frequency, nocturia, and abdominal pain or back pain.

The radiology imaging investigations of lymphoma of the urinary bladder tend to reveal sub-mucosal masses.

Macroscopic examination of lymphomas of the urinary bladder show discrete tumours which are large and centred in the dome or lateral walls of the urinary bladder.

Positive staining of lymphomas of the urinary bladder varies by the sub-type of lymphoma; B-cell lymphomas are CD20 positive.

MALT lymphoma tends to be positively stained for CD20, CD19, and they tend to be negatively stained for CD5, CD10, CD11c but they also tend to be positively stained for FMC7.

Lymphomas of the urinary bladder tend to stain negatively with Pan-keratin, vimentin, CK20 and CK7.

MALT lymphoma exhibit t (11; 18) (q21: 21).

Radiotherapy is the treatment for the MALT type of lymphoma of the urinary bladder and usually there is no recurrence of tumour following such treatment

Conclusions: Lymphoma of the urinary bladder could be either primary or secondary lymphoma.

Diagnosis of lymphoma of the urinary bladder is based upon the characteristic morphology of the bladder lesion which has been resected or biopsied and this must be supported by immunohistochemical analysis.

Lymphoma of the urinary bladder is a rare lesion.

Radiotherapy is a useful treatment for lymphoma of the urinary bladder.