{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:10:54Z","timestamp":1788135054335,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Primary bladder diffuse large B-cell lymphoma (PB-DLBCL) is an exceedingly rare form of non-Hodgkin lymphoma, accounting for only 0.2% of all extranodal lymphomas. Here we report a case of PB-DLBCL in a woman presenting with hematuria. To determine the disease stage, an <jats:sup>18<\/jats:sup>F-FDG PET\/CT scan was performed after surgery. However, intense physiological <jats:sup>18<\/jats:sup>F-FDG activity within the bladder lumen obscured potential lesions and concurrent CT imaging revealed suboptimal bladder distension limiting anatomical delineation. To address these limitations, 20\u202fmg of intravenous furosemide was administered. Delayed imaging was performed 2\u202fh after <jats:sup>18<\/jats:sup>F-FDG injection (1\u202fh after diuretic administration), revealing a focal hypermetabolic lesion in the left bladder wall. This metabolic pattern confirmed the diagnosis of PB-DLBCL, staged as IE according to the Ann Arbor classification. Following 4\u202fcycles of R-CHOP chemotherapy, an <jats:sup>18<\/jats:sup>F-FDG PET\/CT scan was performed for treatment response assessment, confirming complete metabolic remission of the PB-DLBCL. This case highlights that dual-phase <jats:sup>18<\/jats:sup>F-FDG PET\/CT with intravenous diuretics can reduce bladder background activity and improve lesion visualization. Moreover, this approach holds significant clinical value in assisting with disease staging and evaluating treatment response.<\/jats:p>","DOI":"10.3389\/fmed.2025.1613673","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T04:10:30Z","timestamp":1753071030000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Primary bladder diffuse large B-cell lymphoma: a rare case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Ya","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianwen","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiong","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"956","DOI":"10.3390\/curroncol29020081","article-title":"Primary diffuse large B-cell lymphoma of the urinary bladder: update on a rare disease and potential diagnostic pitfalls","volume":"29","author":"Zanelli","year":"2022","journal-title":"Curr Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s12894-024-01616-3","article-title":"Primary lymphoma of mucosa associated lymphoid tissue (MALT lymphoma) in the urinary bladder mimicking recurrent urinary tract infection: a case report and literature review","volume":"24","author":"Liang","year":"2024","journal-title":"BMC Urol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/s2352-3026(20)30357-4","article-title":"The role of PET in first-line treatment of Hodgkin lymphoma","volume":"8","author":"Trotman","year":"2021","journal-title":"Lancet Haematol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"W91","DOI":"10.2214\/AJR.09.2637","article-title":"Clinical utility of PET\/CT in lymphoma","volume":"194","author":"Cronin","year":"2010","journal-title":"AJR Am J Roentgenol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.humpath.2015.03.004","article-title":"Pseudocarcinomatous hyperplasia associated with primary lymphoma in the urinary bladder: a case report","volume":"46","author":"Montironi","year":"2015","journal-title":"Hum Pathol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.4103\/0973-1482.179071","article-title":"Two cases of non-Hodgkin lymphoma of urinary bladder: primary and secondary","volume":"13","author":"D'Souza","year":"2017","journal-title":"J Cancer Res Ther"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e20825","DOI":"10.1097\/md.0000000000020825","article-title":"Primary bladder mucosa-associated lymphoid tissue lymphoma: a case report and literature review","volume":"99","author":"Xu","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3899","DOI":"10.21037\/tau-21-602","article-title":"Bladder mucosa-associated lymphoid tissue lymphoma progressed from chronic cystitis along with a comparative genetic analysis during long-term follow-up: a case report","volume":"10","author":"Ishibashi","year":"2021","journal-title":"Transl Androl Urol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"10024","DOI":"10.12998\/wjcc.v9.i32.10024","article-title":"Primary mucosal-associated lymphoid tissue extranodal marginal zone lymphoma of the bladder from an imaging perspective: a case report","volume":"9","author":"Jiang","year":"2021","journal-title":"World J Clin Cases"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.4103\/jcrt.jcrt_238_21","article-title":"Primary urinary bladder marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue","volume":"18","author":"Katano","year":"2022","journal-title":"J Cancer Res Ther"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1042459","DOI":"10.3389\/fonc.2022.1042459","article-title":"Rare primary bladder mucosa-associated lymphoid tissue lymphoma: a case report and review of literature","volume":"12","author":"Tu","year":"2022","journal-title":"Front Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"4340","DOI":"10.3390\/jcm13154340","article-title":"Primary bladder lymphoma with Extravesical extension: a case report and literature review on prognosis and clinical characteristics","volume":"13","author":"Seki","year":"2024","journal-title":"J Clin Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1016\/j.asjsur.2023.12.050","article-title":"Primary diffuse large B-cell lymphoma of the urinary bladder: a case report","volume":"47","author":"Xin","year":"2024","journal-title":"Asian J Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1056\/NEJMra2027612","article-title":"Diffuse large B-cell lymphoma","volume":"384","author":"Sehn","year":"2021","journal-title":"N Engl J Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1097\/RLU.0b013e31821c99cd","article-title":"Imaging of extranodal lymphoma with PET\/CT","volume":"36","author":"Ilica","year":"2011","journal-title":"Clin Nucl Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"327917","DOI":"10.1155\/2014\/327917","article-title":"Lymphoma of the urinary bladder","volume":"2014","author":"Venyo","year":"2014","journal-title":"Adv Urol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1007\/s12672-025-01958-w","article-title":"Diffuse large B cell lymphoma (DLBCL): epidemiology, pathophysiology, risk stratification, advancement in diagnostic approaches and prospects: narrative review","volume":"16","author":"Berhan","year":"2025","journal-title":"Discov Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"6989","DOI":"10.21873\/anticanres.12167","article-title":"Primary urinary tract lymphoma: rare but aggressive","volume":"37","author":"Lontos","year":"2017","journal-title":"Anticancer Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1148\/rg.262055172","article-title":"From the archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation","volume":"26","author":"Wong-You-Cheong","year":"2006","journal-title":"Radiographics"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2611","DOI":"10.1177\/02841851231179178","article-title":"Imaging evaluation of Para-aortic lymph nodes in cervical cancer","volume":"64","author":"Zhu","year":"2023","journal-title":"Acta Radiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.3349\/ymj.2014.55.6.1467","article-title":"Role of 18F-FDG PET\/CT in the carcinoma of the uterus: a review of literature","volume":"55","author":"Musto","year":"2014","journal-title":"Yonsei Med J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3760\/cma.j.cn321828-20240924-00333","article-title":"Clinical application guideline for PET\/CT and PET\/MR imaging in lymphoma (2025 edition)","volume":"45","year":"2025","journal-title":"Chin J Nucl Med Mol Imaging"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.2967\/jnumed.121.263067","article-title":"The impact of semiautomatic segmentation methods on metabolic tumor volume, intensity, and dissemination Radiomics in (18)F-FDG PET scans of patients with classical Hodgkin lymphoma","volume":"63","author":"Driessen","year":"2022","journal-title":"J Nucl Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1002\/hon.3025","article-title":"Prognostic value of lesion dissemination in doxorubicin, bleomycin, vinblastine, and dacarbazine-treated, interimPET-negative classical Hodgkin lymphoma patients: a radio-genomic study","volume":"40","author":"Durmo","year":"2022","journal-title":"Hematol Oncol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.annonc.2020.11.019","article-title":"Risk stratification in diffuse large B-cell lymphoma using lesion dissemination and metabolic tumor burden calculated from baseline PET\/CT(dagger)","volume":"32","author":"Cottereau","year":"2021","journal-title":"Ann Oncol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1007\/s00259-012-2294-6","article-title":"Diuretic 18F-FDG PET\/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique","volume":"40","author":"Nayak","year":"2013","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"6090","DOI":"10.3390\/jcm13206090","article-title":"Pre-hydration and a forced diuresis protocol for (18)F-FDG PET\/CT yielded an optimal effect on primary pelvic malignancies","volume":"13","author":"Hsieh","year":"2024","journal-title":"J Clin Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/01.rlu.0000167482.23562.ab","article-title":"High-grade lymphoma of the bladder visualized on PET","volume":"30","author":"Mantzarides","year":"2005","journal-title":"Clin Nucl Med"},{"key":"ref29","first-page":"500","article-title":"Value of dual-phase (18)F-FDG PET\/CT in preoperative staging of bladder cancer","volume":"34","author":"Li","year":"2014","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"11","DOI":"10.4274\/mirt.galenos.2023.65002","article-title":"The added-value of staging (18)F-FDG PET\/CT in the prediction of overall survival in the patients with bladder Cancer","volume":"33","author":"Ate\u015f","year":"2024","journal-title":"Mol Imaging Radionucl Ther"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1097\/00000478-199711000-00007","article-title":"Malignant lymphoma of the bladder: evidence from 36 cases that low-grade lymphoma of the MALT-type is the most common primary bladder lymphoma","volume":"21","author":"Kempton","year":"1997","journal-title":"Am J Surg Pathol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1038\/35000501","article-title":"Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling","volume":"403","author":"Alizadeh","year":"2000","journal-title":"Nature"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1002\/ajh.26151","article-title":"2021 update on diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management","volume":"96","author":"Susanibar-Adaniya","year":"2021","journal-title":"Am J Hematol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"322","DOI":"10.3760\/cma.j.cn121090-20231228-00343","article-title":"Chinese expert consensus on the diagnosis and management of elderly patients with diffuse large B-cell lymphoma","volume":"45","year":"2024","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e746","DOI":"10.1016\/s2666-7568(21)00213-0","article-title":"Palliative care of patients with haematological malignancies: strategies to overcome difficulties via integrated care","volume":"2","author":"Wedding","year":"2021","journal-title":"Lancet Healthy Longev"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1613673\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T04:10:32Z","timestamp":1753071032000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1613673\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":35,"alternative-id":["10.3389\/fmed.2025.1613673"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1613673","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,21]]},"article-number":"1613673"}}