Mantle cell diffuse large B-cell lymphoma revealed by lower urinary tract symptoms: A case report and literature review

Abstract

INTRODUCTION: Mantle cell lymphoma with diffuse large B cell lymphoma transformation (MCL-DLBCL) is a rare and aggressive form of lymphoma that typically presents with non-specific symptoms. It is uncommon for this lymphoma to manifest as lower urinary tract symptoms (LUTS), such as dysuria, hematuria, and pelvic pain, often leading to misdiagnosis and delayed treatment. CASE PRESENTATION: We present the case of a 62-year-old male patient who presented with irritative urinary symptoms. After a series of diagnostic tests, including imaging (MRI, PET-CT) and histopathological analysis, the final diagnosis was mantle cell lymphoma (MCL) with transformation into mantle cell diffuse large B-cell lymphoma (MCL-DLBCL) involving the prostate, lymph nodes, and stomach. Prostate biopsy and immunohistochemical analysis confirmed this diagnosis. DISCUSSION: This case highlights the rare presentation of MCL-DLBCL with urinary symptoms. The role of advanced imaging techniques, such as MRI and PET-CT, in identifying the involved organs is emphasized. The study also underscores the importance of prostate biopsy and immunohistochemical analysis to confirm the diagnosis and distinguish between MCL transformation into MCL-DLBCL or a composite lymphoma. A multidisciplinary approach is crucial for early detection and proper management. CONCLUSION: The patient received a combination of chemotherapy, including rituximab and other agents, leading to complete remission. After chemotherapy, the patient underwent autologous hematopoietic stem cell transplantation, contributing to his recovery.