CASE Metachronous non-Hodgkin’s lymphoma in a patient with localized prostate cancer Mehmet E. Kalender Æ Alper Sevinc Æ Ediz Tutar Æ Suleyman Buyukberber Æ Celalettin Camci Received: 28 February 2007 / Accepted: 12 March 2007 / Published online: 17 May 2007 Ó Humana Press Inc. 2007 Abstract Introduction A higher frequency of second malignancies is observed in patients with prostate cancer. We report a case of indolent non-Hodgkin’s lymphoma diagnosed 2 years after prostate carcinoma. Case report A 65-year-old man with diagnosis of local- ized prostate adenocarcinoma was presented with fatigue 2 years after prostatectomy operation. Abdominal ultraso- nography showed hepatomegaly and paraaortocaval, para- iliac, and perivascular multiple lymph nodes. The complete blood count revealed anemia and thrombocytopenia. Bone marrow biopsy demonstrated small lymphocytic lym- phoma. Conclusion Lymphoma should be suspected in cases with newly appeared adenopathy and/or cytopenias during fol- low-up. In patients with clinically organ-confined prostate cancer, indolent lymphoma should be in the differential diagnosis of newly appeared lymphadenopathy. Keywords Prostate cancer Á Localized Á Lymphadenopathy Á Metachronous Á Non-Hodgkin’s lymphoma Á Prostatectomy Introduction Prostate cancer is the most common non-cutaneous cancer in the western world. It is a leading cause of mortality and morbidity worldwide. Treatment of metastatic disease has generally aimed at increasing symptom free survival in asymptomatic patients and improving quality of life in symptomatic patients. However, localized prostate carci- noma is known to be a curable disease. Indolent lymphoma is a systemic illness that is generally not considered curable and will eventually require aggressive therapy in many otherwise healthy patients. In the English literature, synchronous lymphoma in patients with prostate cancer has been reported [1–7]. A detailed search did not reveal metachronous lymphoma in those patients. In case of newly appeared lymphadenopathy during the follow-up of a patient with localized prostate cancer, it is important to exclude metastasis of the known cancer and establish the diagnosis of an unexpected second malignancy. We report a case of metachronous indolent non-Hodgkin’s lymphoma diagnosed 2 years after prosta- tectomy operation. Case report A 65-years-old man with localized adenocarcinoma of the prostate (Fig. 1) was presented with fatigue 2 years after the prostatectomy operation. He was commenced leupro- lide 3.75 mg monthly and flutamid 300 mg/day for the last two years. The physical examination was normal except hepatomegaly. The complete blood count showed; hemo- globin 4.4 g/dL, hematocrit 0.12, mean corpuscular vol- ume 102.8 fL, platelets 48.100/mm 3 , and erythrocyte sedimentation rate 120 mm/h. Liver and renal function M. E. Kalender Á A. Sevinc (&) Á C. Camci School of Medicine, Department of Medical Oncology, Gaziantep Oncology Hospital, Gaziantep University, Gaziantep 27310, Turkey e-mail: sevinc@gantep.edu.tr E. Tutar School of Medicine, Department of Pathology, Gaziantep University, Gaziantep 27310, Turkey S. Buyukberber School of Medicine, Department of Medical Oncology, Gazi University, Ankara, Turkey Med Oncol (2007) 24:466–468 DOI 10.1007/s12032-007-0024-x