Main Article Content
Chronic lymphocytic leukaemia, Non-visible Hematuria, Storage lower urinary tract symptoms, Chemotherapy, Multi-disciplinary team
Chronic lymphocytic leukemia (CLL) is an uncommon hematological disease affecting people with recurring infection and is associated with increased risk of progression to high-risk cancer. Bladder CLL is a rare disease hence prognosis and best treatment option is not clearly understood. CLL commonly affects middle-aged women. It presents as abdominal pain, urinary difficulty, fatigue and general symptoms like fever, weight loss and loss of appetite. Chemotherapy, surgery, and radiation is the mainstay of treatment. Prognosis depends on multiple factors including subtype, stage of lymphoma, the progression of the condition, response to treatment, and overall health of the patient. The risk of recurrence and progression to other cancer is very high in bladder CLL which necessitates a strict follow-up protocol. We present a case of an 87-years-old patient presenting with persistent non-visible hematuria and storage lower urinary tract symptoms. Hematuria workup leads to the diagnosis of CLL. Hematology multi-disciplinary team recommended follow up.
2. Cancer Research UK. Available at: http://www.cancerresearchuk.org/about-cancer/type/cll/about/chronic-lymphocytic-leukaemia-risks-and-causes
3. Lishner M, Prokocimer M, Ron E, Shaklai M. Primary malignant neoplasms associated with chronic lymphocytic leukemia. Postgrad Med J 1987;63:253–56 [PubMed].
4. Tsimberidou AM, Wen S, McLaughlin P, et al. Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol 2009;27(6):904–10.
5. National Health Service. NHS Hematuria Pathways. Available at: http://www.ouh.nhs.uk/services/referrals/renal/documents/hematuria-pathways.pdf
6. Baseskiogulu B, et al. The type of lymphocyte infiltration near urothelial carcinoma is diagnostic for chronic lymphocytic leukemia. Urol Ann 2013 Jan;5(1):47–9
7. Prashant V, et al. Malt Lymphoma of the Bladder: A Case Report and Review of Literature. Case Rep Haematol 2015;(934374).