Primary diffuse large B-cell lymphoma of adrenal gland: A case report.

INTRODUCTION: Most adrenal tumors are benign and primary adrenal malignancies are relatively rare. Primary adrenal lymphoma (PAL) is a very rare and highly aggressive malignant tumor with unknown etiology, atypical clinical symptoms, nonspecific imaging manifestations, difficult disease diagnosis and poor prognosis. CASE REPORT: This case report details a 42-year-old woman who was admitted to the hospital with a 1-year-old bilateral adrenal mass and 1-month-old left upper abdominal pain. Enhanced CT of the abdomen showed a right adrenal nodule and a large occupying lesion in the left adrenal region, with a high probability of pheochromocytoma. Intraoperatively, a huge tumor measuring about 12*12*10 cm was found in the left adrenal region, infiltrating the left kidney, spleen and pancreatic tail. Postoperative pathology: lymphocytes were found in the renal capsule and subcapsule, lymphocytes were found in the pancreas; lymphocytes were found in the spleen. Consider a tumor of the lymphohematopoietic system, possibly lymphoma. CONCLUSION: This case demonstrates that primary adrenal diffuse large B-cell lymphoma (PADLBCL) is highly aggressive, has a poor prognosis, is prone to recurrence, has poor therapeutic outcomes, and is difficult to diagnose. Clinicians should consider the possibility of PADLBCL when encountering huge adrenal-occupying lesions and consider chemotherapy before surgery. Reducing the tumor size before surgery is a more favorable therapeutic approach, thus prolonging the patient life and improving the quality of survival.

Bladder malacoplakia: A case report.

BACKGROUND: Bladder malacoplakia is a rare chronic granulomatous disease. The most common site of the malacoplakia is the urinary system. The etiology of bladder malacoplakia is complex, with its clinical misdiagnosis rate is high. Therefore, exposure to more clinical cases is necessary to improve the diagnosis and treatment of this condition. CASE SUMMARY: A 65-year-old woman was admitted to our hospital because of dysuria. She presented with dysuria, frequent urination, urgency, pain, and absence of hematuria and pyuria. After the examination, bladder tumor electrocision was performed under combined intravenous and inhalation anesthesia on September 6, 2021. During the operation, electrotomy and electrocoagulation were performed. The operation was then followed by anti-infection treatment, and the patient recovered well. The postoperative pathology was diagnosed as bladder malacoplakia by light and electron microscopic analyses. On a follow-up after 4 mo, no significant difference between electrotomy and electrocoagulation was found, with both achieving a curative effect. CONCLUSION: Diagnosing bladder malacoplakia depends on histopathological examination. Antibiotic treatment with bladder tumor resection or electrocoagulation provides better therapeutic effect.

Bladder triangle amyloidosis: A case report and literature review.

RATIONALE: Amyloidosis is a group of benign lesions characterized by extracellular deposition of amyloid proteins. Amyloidosis lesions can occur in various organs of the body, but rarely in the urinary system. Amyloidosis in the bladder trigone is extremely rare. PATIENT CONCERNS: An 80-year-old female patient presented with painless whole-course gross hematuria with reddish urine and no blood clots, accompanied by right lumbar discomfort. DIAGNOSIS: Based on the patient's medical history and cystoscopy findings, the relevant literature was reviewed and a preoperative diagnosis of bladder tumor was made, although bladder amyloidosis was not excluded. Postoperative pathology ultimately revealed bladder amyloidosis. INTERVENTIONS: The patient underwent resection of bladder tumor and ureteral stent implantation. Postoperatively, the patient was maintained on antibiotics and oral colchicine treatment. OUTCOMES: Two months after surgery the patient reported that the gross hematuria had disappeared, and that the right lumbar discomfort was significantly relieved.Cystoscopy showed no obvious recurrence in the operative area, but magnetic resonance imaging (MRI) suggested recurrence. The patient refused partial cystectomy, and the ureteral stent was removed. LESSON: The clinical manifestations of bladder amyloidosis are nonspecific, and under cystoscopy can be easily confused with bladder tumors. Accurate diagnosis of bladder amyloidosis relies on histopathology. Transurethral resection of bladder tumors or partial cystectomy is an option for surgical treatment; the latter should be performed if the ureteral opening is involved.