Objectives: Primary prostatic malignant lymphoma is an exceedingly rare malignancy, accounting for only 0.09% of all prostate neoplasms and 0.1% of all non-Hodgkin's lymphomas. In this report, we present a case of a 70-year-old male patient who presented with sudden-onset hematuria and was ultimately diagnosed with primary lymphoma of the prostate. Methods: The patient presented to a urology outpatient clinic with a 2-week history of gross hematuria but no lower urinary tract symptoms. Digital rectal examination revealed a firm and enlarged prostate, and serum PSA levels were elevated. Ultrasound evaluation, multiparametric prostate magnetic resonance imaging (mp-MRI), and cystoscopy were performed, revealing only a grossly enlarged prostatic median lobe. A systematic transrectal ultrasound (TRUS)-guided prostate biopsy was then performed and confirmed the diagnosis of primary lymphoma of the prostate. Results & Conclusion: This case highlights the importance of considering primary lymphoma of the prostate in patients presenting with macroscopic hematuria and an enlarged prostate, even if mp-MRI does not reveal any other abnormalities. Early diagnosis is crucial in such cases, as it allows for prompt initiation of treatment and may improve clinical outcomes. Given the rarity of this malignancy, clinicians must remain vigilant for its possible presentation and include it in the differential diagnosis when appropriate.

Prostate, Lymphoma, Hematuria

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