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CASE REPORT

Rare metastatic prostate cancer mimicking lymphoma with malignant pleural effusion


1 Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Division of Urological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Yi-Ming Chang,
Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei City 114
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_16_21

Prostate cancers commonly metastasize to the pelvic lymph nodes and bones, but malignant pleural effusion rarely occurs. Prostate cancer lesions rarely cytologically mimic lymphomas. We present the case of a 70-year-old man with a history of chronic obstructive pulmonary disease and prostate cancer after hormone therapy, as well as a rare manifestation of pleural effusion. Chest radiography revealed a large amount of left pleural effusion. The cytological analysis of the pleural fluid purely consisted of single tumor cells, which were not immunoreactive to Nkx3.1 or prostate-specific antigen. This was initially misinterpreted as a lymphoma. However, a further pleural biopsy revealed immunoreactivity to Nkx3.1, suggesting metastatic prostate cancer. This study showed that cytology and further biopsy effectively distinguished between Gleason 5 prostate cancer and lymphoma in a patient with pleural effusion.


 

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