Primary Non-Hodgkin Lymphoma of the Urinary Bladder in the Paediatric Age Group: A Report of a Rare Case

Primary non-Hodgkin lymphoma (NHL) of the urinary bladder in the paediatric age group is an unusual neoplasm. Patients mostly present with haematuria, lower urinary tract symptoms and abdominal pain. The clinical, radiological and histological findings are non-specific. It is difficult to differentiate it from more common congeners in this age bracket, such as rhabdomyosarcoma, on the basis of imaging. The diagnosis is made on the basis of histopathological characteristics and is confirmed by immunohistochemical (IHC) analysis. Herein, we report a case of a six-year-old male child who presented with lower urinary tract symptoms and abdominal pain for a duration of two months. He was further evaluated using cross-sectional imaging, and histopathological examination with immunohistochemistry confirmed the diagnosis of NHL (Burkitt lymphoma). He was treated with one cycle of COP (cyclophosphamide, oncovin and prednisone), followed by one cycle of COPDAM (cyclophosphamide, oncovin, prednisone, doxorubicin (Adriamycin) and methotrexate). Follow-up contrast-enhanced computed tomography (CECT) revealed a 60% reduction in tumour size. This case highlights the importance of early diagnosis based on histopathology and IHC, and demonstrates that timely initiation of appropriate chemotherapy can lead to favourable outcomes in NHL.