Primary Classical Hodgkin Lymphoma of the Urinary Bladder: Expanding the Spectrum of Bladder Lymphoid Neoplasms.
Sinem Eser Polat Ünal, Dinç Süren, Erdal Kurtoğlu
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Case in brief
A 71-year-old woman presented with hematuria and urinary incontinence. PET/CT showed a hypermetabolic mass in the posteroinferior bladder wall invading the anterior vaginal wall, with regional pelvic lymph node involvement. Transurethral resection showed classical Reed-Sternberg cells in a mixed inflammatory infiltrate. The cells expressed weak PAX5, CD30, CD15, and EBER, while lacking LCA, B-cell markers, and T-cell markers. With no systemic involvement, the findings supported a diagnosis of primary classical Hodgkin lymphoma of the bladder.
What made this case unusual
The bladder lesion was diagnosed as primary classical Hodgkin lymphoma rather than secondary involvement by systemic disease, an exceptionally uncommon presentation.
Diagnostic / clinical pearl
In a bladder tumor with atypical morphology, consider classical Hodgkin lymphoma and use histology with immunophenotyping and assessment for systemic involvement to establish the diagnosis.