Work

Case report: Can fibrinolytics effectively manage gross hematuria and clot retention in an elderly patients, leading to the diagnosis of lymphoma?

Year: 2025

Type: article

Abstract: A 77-year-old man presented with severe gross hematuria and extensive urinary tract clot retention unresponsive to catheterization and irrigation. CT showed clots throughout the upper and lower tracts; labs revealed pancytopenia and elevated creatinine. Bilateral nephrostomies with multiple Alteplase instillations dissolved clots, restored urinary flow, and normalized renal function. Bone marrow biopsy confirmed B-cell lymphoma. This case highlights fibrinolytic therapy as a minimally invasive option for clot retention and the importance of multidisciplinary evaluation in uncovering malignancies presenting with complex urologic emergencies. • Alteplase successfully dissolved extensive urinary tract clots. • Multidisciplinary approach revealed B-cell lymphoma. • Fibrinolytics offer a minimally invasive alternative to surgery. • Case emphasizes diagnostic vigilance in elderly hematuria. • Restoration of renal function avoided further dialysis.

Source: Urology Case Reports

DOI: 10.1016/j.eucr.2025.103253

Authors: Moein Bighamian, Maryam Sadat Jamadi, Amin Dorostkar, Farid Rajaee Rizi

Institution: Isfahan University of Medical Sciences

Language: English

Topic: Venous Thromboembolism Diagnosis and Management

Subfield: Internal Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,160