Urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome.

We report the first case (to our knowledge) of a primary urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome. A 36-year-old white homosexual man with antibodies to human immunodeficiency virus type 1 was evaluated for a hemorrhagic urethral discharge. A 2-cm fleshy, polypoid mass in the bulbous urethra was removed, and the diagnosis of small non-cleaved cell (non-Burkitt's) lymphoma was made. Immunohistochemical analysis confirmed that the tumor was of T-cell lineage. Patients with the acquired immunodeficiency syndrome have an increased incidence of lymphomas, particularly extranodal high-grade non-Hodgkin's lymphomas. Primary urethral lymphomas are extremely rare, with only a handful of cases reported in the literature. This rare form and site of lymphoma should be considered in patients with the acquired immunodeficiency syndrome who have genitourinary symptoms.