Suspicious Atypical B-Cell Infiltrates—Significance of Work-up in Urinary and Male Genital Organs

Genitourinary tract lymphomas are rare and comprise <5% of extranodal lymphomas. Information on prevalence in urinary and male genital tract (GU) organs is limited. A retrospective study of the B-cell lymphomas in the GU organs (kidney, prostate, bladder, testis, and ureter) between January 1, 2011, and September 16, 2021, at our institution was performed. A total of 39 specimens with lymphoma in the GU organs were identified, 51% of which were primary. The most common diagnosis within the primary subgroup was diffuse large B-cell lymphoma (60%), followed by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL, 15%) and extranodal marginal zone lymphoma (EMZL, 15%) and follicular lymphoma (5%). Kidney was the most common site (36%), followed by testes (20%), bladder (15%), and prostate (13%). All testicular lymphomas were primary. Most bladder lymphomas were secondary (83%). Most of these were either discovered incidentally or presented with organ-specific symptoms. We also identified an interesting example of primary EMZL involving both prostate and bladder and another one of proliferative glomerulonephritis with monoclonal IgG kappa immunoglobulin deposits due to primary CLL/SLL of the kidney. Our study highlights the importance of hematopathologic workup for specimens suspicious for a typical B cell infiltrates in surgical pathology practice.