Primary cervical lymphoma: Report of two cases and review of the literature

Department of Obstetrics and Gynecology, Hacettepe University, Engüri, Ankara, Turkey
Gynecologic Oncology (Impact Factor: 3.77). 10/2005; 98(3):484-9. DOI: 10.1016/j.ygyno.2005.04.040
Source: PubMed


Primary lymphoma arising from the female genital tract has been rarely encountered. Primary cervical lymphoma is even rarer in gynecologic oncology practice and accounts for approximately only 1% of extranodal lymphomas. In this article, two cases of cervical lymphoma are presented with a review of the available literature.
A 51-year-old woman presented with abnormal vaginal discharge. On pelvic examination, cervix was apparently normal; however, a solid and mobile pelvic mass was palpated. Pap smear was reported as HSIL at another institution. Radiological evaluation revealed a cervical mass with a 3 cm diameter. Histopathological evaluation of LEEP material was reported as diffuse large B cell lymphoma. We performed abdominal hysterectomy plus bilateral salphingo-oopherectomy and the patient was treated with adjuvant 6 cycles of CHOP chemotherapy. A second case was a 49-year-old postmenopausal woman who had undergone a routine gynecologic follow-up examination without any complaint at another institution. Routine cytological smear revealed HSIL. Punch biopsy under colposcopic examination presented no remarkable pathology except for a benign inflammation. Due to discordance between cytology and histology, LEEP was performed under colposcopic examination, which revealed follicular lymphoma grade III. This patient was treated with 6 cycles CHOP chemotherapy without any surgery.
Primary cervical lymphoma is a rare disorder. Although most reported cases in the literature have a normal Pap smear, some may represent with co-existent cytological abnormalities. Therefore, cervical lymphomas should be kept in mind in patients with cytological abnormalities.

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    • "The gastrointestinal tract is the most common site of primary extranodal lymphoma, but involvement of almost any organ, including the reproductive tract most commonly the cervix, can also occur [2]. The involvement of the cervix in the setting of multiorgan disease as in this report is still rare but more common than primary lymphoma [3] [4]. "
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    ABSTRACT: Non-Hodgkin's lymphoma of the cervix is an extremely uncommon entity, with no standard established treatment protocol. A 43-year-old asymptomatic female with a history of dual hit blastic B-cell lymphoma/leukemia in complete remission presented with an incidental cervical mass, which was initially felt to represent a cervical fibroid on computed tomography (CT). It was further evaluated with ultrasound, biopsy, and positron emission tomography-computed tomography (PET-CT), which demonstrated a growing biopsy-proven lymphomatous mass and new humeral head lesion. The patient was started on chemotherapy to control the newly diagnosed humeral head lesion, which then regressed. She then underwent radiation to the cervix with significant improvement in the cervical lymphoma. A review of cross-sectional imaging findings of lymphoma of the cervix is provided, including how to differentiate it from other more common diseases of the cervix. Clinical awareness of rare cervical masses such as lymphoma is very important in order to achieve timely diagnosis and appropriate treatment.
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    • "Dursun et al in 2005 reviewed 31 reported cases and Korcum et al in 2007 published a review including 56 cases of lymphoma of cervix [6] [7] "
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    ABSTRACT: Primary lymphoma of the uterine corpus and cervix is rare. We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametria with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy. A summary of the published cases focusing on the presentation and prognosis as well as a review of current management are discussed. The rising incidence of extra-nodal lymphoma and recent changes in classification and therapeutic approach, require clinical vigilance. In the absence of prospective studies assessing the value of the available therapeutic options, data from retrospective series and scattered case reports are presented in this review.
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    • "To the best of our knowledge, this is the first case of successful pregnancy occurring after chemo-radiotherapy for PUL. In contrast to concerns about the negative impact of radiotherapy on fertility and teratogenesis, which induced some authors to treat PUL patients with chemotherapy alone (Engin et al, 2004; Dursun et al, 2005), this case suggests that, if preceded by ovarian transposition, postchemotherapy irradiation of the entire uterus with 30 Gy and conventional fractionation can be safety delivered in young PUL patients who wish to have children after cancer. "

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