a 30-year - old woman presented with a two - month history of gross hematuria and dysuria . the urine analysis results were 250/ul of rbc and 500/ul of wbc and the serum albumin level was 2.3 g / dl . intravenous urography revealed a lobulated filling defect and irregular amorphous calcification in the left lateral wall of the urinary bladder , while ultrasonography demonstrated asymmetric hypoechoic diffuse thickening of bladder wall with acoustic shadowing in the left lateral wall suggesting calcification ( fig . 1a ) . pelvic ct depicted eccentric lateral wall thickening with calcification and heterogeneous enhancement ( figs . t1-weighted mr image depicted low - signal - intensity eccentric lateral wall thickening , and t2-weighted mr image demonstrated heterogeneous high signal intensity ( figs . there was a small amount of ascites , but this was probably due to hypoalbuminemia . their radiologic findings , including those of chest radiography and abdominal ct , indicated no lymph node enlargement or hepatosplenomegaly . cystoscopy revealed diffuse hyperemic edematous mucosal change , calcification , and mucosal ulceration of the left lateral wall . ultrasonography - guided biopsy was performed , and histologic examination revealed high - grade peripheral t - cell lymphoma accompanied by focal necrosis ( fig . because lymphoid tissues are not normally found in the bladder , a primary lymphoma rarely occurs there ( 1 - 4 ) . the tumor commonly affects woman and there is often a history of chronic cystitis , considered important etiologically . it has been suggested that the neoplasm associated with chronic cystitis may originate in the lymphocytes present in the submucosa of the bladder as a result of an inflammatory or immune response ( 2 ) . the radiologic findings of urinary bladder lymphoma vary , though from a review of the literature , certain patterns emerge . the tumor appears most frequently as a sessile solitary mass ( 66% ) ; multiple sessile masses are less frequent ( 14% ) , and a polypoid mass is occasionally present ( 10% ) . diffuse thickening of the bladder wall may occur , but is infrequent ( 10% ) . despite these patterns of occurrence , there are no characteristic findings which distinguish lymphoma of the urinary bladder from other tumors ( 1 ) . in our case , ultrasonography and pelvic ct revealed diffuse bladder wall thickening , a finding which can frequently mimic transitional cell carcinoma ( tcc ) ( 1 , 2 ) . pre - treatment calcification in lymphoma patients is extremely rare , and its pathogenesis is uncertain . generally , tissue calcifications is metastatic or dystrophic ( 5 - 7 ) ; the former is caused by excessive or unstable calcium ion concentration in the blood . in our case , however , this level was normal , and this explanation was thus less likely . dystrophic calcification , on the other hand , frequently occurs in degenerated or necrotic tissue ( 6 ) , conditions which result from infarction and lead to calcification . such infarction occurs typically in histologically aggressive lymphoma ( 7 ) . in our case , high grade t - cell lymphoma accompanied by necrosis was diagnosed , and the pathogenesis for calcification was probably a dystrophic calcification . in tcc and urachal carcinoma , calcification occurs within the bladder wall . infiltration appears to be more diffuse in lymphoma than in tcc , and in the former , hydronephrosis seems to be uncommon ( 8) . schistosomiasis may produce mural calcification which shows with a typical thin arcuate pattern , and may also be associated with calcification in other parts of the urinary tract . other entities that cause bladder wall injury can predispose to dystrophic calcification and include alkaline incrusted cystitis , cytotoxin cystitis , radiation therapy , and tuberculosis ( 9 ) . treatment of primary lymphoma of the urinary bladder is not uniform and the procedures employed have included radical cystectomy , radiation therapy , and chemotherapy . for prognosis , histologic grade is probably a useful indicator , and the overall prognosis appears to be good ( 2 ) . in summary , we report a case of primary lymphoma of the urinary bladder associated with dense internal calcification . a case of this nature
primary malignant lymphoma of the urinary bladder is extremely rare , and to our knowledge , no case described in the radiologic literature has been accompanied by calcification . 
 we report a case in which the condition was associated with calcification , and describe the pelvic ct and mr imaging findings .