Ewha Med J.  2021 Apr;44(2):41-45. 10.12771/emj.2021.44.2.41.

Primary Lymphoma of Cervix

• Shim JE
• Kim J
• Kim MK
• Kim YH
• Kim SC

• KMID: 2515272
• DOI: http://doi.org/10.12771/emj.2021.44.2.41

Abstract

Lymphomas that originate from the female genital tract are very rare. Primary cervical lymphoma only accounts for less than 1% of all extra-nodal lymphomas. Clinical manifestations of primary cervical lymphoma can be nonspecific, vaginal bleeding being the most common symptom, and this makes timely diagnosis often difficult. Prognosis and optimal treatment have yet been established due to the rarity of the disease. In this article, a rare case of primary diffuse large B-cell lymphoma of cervix is reported with a review of the available literature.

Keyword

Uterine cervical neoplasms; Cervix uteri; Lymphoma; Lymphoma; B-cell

Figure

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  Fig. 1 (A, B) PET-CT shows hypermetabolic cervical mass (arrow) involving left parametrium with multiple metastatic lymph nodes with right hydroureterosis. (C, D) T2-weighted image of magnetic resonance imaging shows large cervical mass (arrows) of low signal intensity. A written informed consent for publication and use of medical data and images was obtained from the patient.

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  Fig. 2 Pathological evaluation and findings. (A) Diffuse tumor infiltration in cervical stroma (H&E, ×40), (B) atypical lymphoid cells with large/intermediate size and high nucleus-cytoplasm ratio (H&E, ×400), (C) pan-cytokeratin negative (×40), (D) CD56 negative (×40), (E) chromogranin negative (×40), (F) synaptophysin negative (×40), (G) CD20 positive (×40), (H) CD3 negative (×40), (I) Ki-67 50% to 70% positive (×40), and (J) Epstein-Barr virus-encoded small RNA negative (×40) in tumor cells. Fluorescence in situ hybridization analysis performed on cervical mass specimen revealed (K) BCL-2 translocation negative, (L) BCL-6 translocation positive, (M) C-MYC translocation positive, which suggest double hit lymphoma.

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  Fig. 3 (A) PET-CT and (B) abdomen and pelvis CT taken as response check after 5 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, showing partial response with markedly decreased size of cervical mass (arrow) and lymph nodes. Small residual lesion in uterine cervix remained. A written informed consent for publication and use of medical data and images was obtained from the patient.

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