Primary ureteral lymphoma presenting as bilateral obstructive uropathy

Primary ureteral lymphomas are rare. We present a case of extranodal B-cell lymphoma of the ureter presenting as asymptomatic bilateral ureteral obstruction. A 34-year-old male was incidentally found to have obstructive uropathy. Imaging showed severe bilateral hydronephrosis and percutaneous nephroureteral stents were placed. Diagnostic work up did not uncover any apparent etiology to the obstruction. Histopathological analysis of the ureter excised during ureteral reimplantation revealed CD20+, CD5−, CD10− B-cell lymphoma with areas of aggressive disease. The patient received six cycles of R-CHOP chemotherapy and is currently disease free.