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- VRU case report
Ashika Seshadri 1, Britt Thevelein 2, Brian Thomas Huber 3, Michael Perlini 3
Background
Prostatic lymphoma is an uncommon form of neoplasia in dogs, typically occurring as part of systemic lymphoid malignancy. Uroperitoneum, caused by urine leakage into the abdominal cavity, is rare in cases of prostatic neoplasia. This case report describes a dog diagnosed with prostatic lymphoma associated with uroperitoneum, marking the first documented case of urine extravasation through the prostatic parenchyma due to lymphoma.
Methods
A 10-year-old neutered male Labrador mix presented with stranguria, dysuria, and progressive urinary retention. Diagnostics included:
-Abdominal radiographs to assess the urinary tract and rule out calculi.
-Ultrasound evaluation of the prostate and urinary bladder.
-Fluoroscopic retrograde cystourethrogram to investigate urine leakage.
-Fine-needle aspiration (FNA) cytology of the prostate and peritoneal effusion.
Results
Imaging Findings:
-Radiographs: Loss of serosal detail, prostatomegaly, no evidence of urinary calculi.
Ultrasound:
-Enlarged, heterogeneous prostate with hyperechoic foci (suggesting mineralization).
-Multifocal hypoechoic nodules and ill-defined areas of vascularization.
-Mild medial iliac lymphadenopathy and hepatic nodules.
Fluoroscopy (retrograde cystourethrogram):
-Contrast extravasation from the prostatic urethra into the peritoneal cavity.
-No evidence of bladder rupture or urethral calculi.
Cytology & Diagnosis:
-Prostatic FNA: Large lymphocytes with malignant features, confirming prostatic lymphoma.
-Peritoneal fluid analysis: Modified transudate with lymphocytic infiltration, consistent with uroperitoneum due to lymphoma.
Outcome:
-Due to poor prognosis and progressive clinical signs, euthanasia was elected.
-Necropsy was declined, so further histopathological confirmation was unavailable.
Limitations
This report describes a single case, limiting generalizability. Lack of necropsy confirmation means that disease extent and histologic subtype could not be fully characterized. Additionally, treatment outcomes were not assessed, as euthanasia was elected at diagnosis.
Conclusions
This is the first reported case of uroperitoneum due to prostatic lymphoma in a dog. Prostatic neoplasia should be considered in dogs with lower urinary tract signs and uroperitoneum, even in the absence of urinary calculi or traumatic injury. Fluoroscopy and ultrasound are valuable diagnostic tools for evaluating urinary tract rupture in complex cases.
Still image of cineloop of fluoroscopic study demonstrat-ing retrograde contrast in the urethra (small black arrow), contrast refluxin the prostatic parenchyma (small white arrow), extravasating into theperitoneum (long black arrow), and filling the urinary bladder.
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