1
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Verrou E, Papageorgiou SG, Bouzani M, Sevastoudi A, Triantafyllou T, Daiou A, Dalampira D, Arapaki M, Giatra C, Banti A, Kyriakidis G, Stoumpos D, Karampatzakis N, Papadopoulou T, Kotsopoulou M, Pouli A, Mandala E, Pappa V, Spanoudakis E, Katodritou E, Vassilakopoulos TP. Clinical characteristics and outcome of early-stage diffuse large B cell lymphoma of female genital track: A retrospective study of the Hellenic cooperative lymphoma group. Hematol Oncol 2024; 42:e3303. [PMID: 39105590 DOI: 10.1002/hon.3303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/23/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024]
Abstract
Involvement of female genital track (FGT) by diffuse large B cell lymphoma (DLBCL) represents an extremely rare diagnosis. Especially data regarding early-stage disease (i.e., IE, IIE) is very limited. Importantly, previous studies showed controversial results about the risk of central nervous system (CNS) relapse in this entity. Herein, we describe one of the largest reported real-world series of patients with early-stage FGT DLBCL aiming to investigate the clinicopathological characteristics, response to therapy and survival outcomes in the era of immunochemotherapy. We analyzed 21 consecutive patients with biopsy proven DLBCL from uterus or ovary classified as stage IE or IIE out of 1905 newly diagnosed DLBCL patients (1.1%). Uterine and ovarian localization was observed in 14 and seven patients, respectively. Median age was 66 years (range 33-96); 9/21 (43%) were <55 years. Regarding Cell of Origin DLBCL subtype, Germinal Center B-cell subtype was found in seven patients, non-GCB in 10 and non-classified in 4 patients. Median follow-up was 57 months and 5-year overall survival, lymphoma specific survival and Freedom from Progression were 78%, 89% and 90%, respectively. There was no correlation of patients' characteristics with survival parameters. Interestingly, none of the patients experienced CNS relapse. Our results indicate that localized FGT DLBCL exhibits a good prognosis and may not increase the risk for secondary CNS involvement.
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MESH Headings
- Humans
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Female
- Middle Aged
- Aged
- Adult
- Retrospective Studies
- Aged, 80 and over
- Neoplasm Staging
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Prognosis
- Survival Rate
- Genital Neoplasms, Female/pathology
- Genital Neoplasms, Female/therapy
- Genital Neoplasms, Female/mortality
- Genital Neoplasms, Female/diagnosis
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Affiliation(s)
- Evgenia Verrou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Bouzani
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | | | | | - Aikaterini Daiou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Dimitra Dalampira
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Maria Arapaki
- Department of Hematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Chara Giatra
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Anastasia Banti
- Department of Hematology, Papageorgiou Hospital, Thessaloniki, Greece
| | | | | | | | | | | | - Anastasia Pouli
- Department of Hematology, Aghios Savvas Cancer Hospital, Athens, Greece
| | - Evdokia Mandala
- Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | | | - Eirini Katodritou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Theodoros P Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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2
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Fan W, Sun S, Wang J, Lv Y, Chen Y. Development and validation of nomograms to predict survival of primary cervical lymphoma: A surveillance, epidemiology, and end results (SEER) database analysis. Medicine (Baltimore) 2024; 103:e38528. [PMID: 38875393 PMCID: PMC11175947 DOI: 10.1097/md.0000000000038528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
Due to the rarity of primary cervical lymphoma (PCL), the long-term survival of patients with cervical lymphoma and factors influencing survival are unknown. This study aimed to compare the survivals of patients with PCL and those with other cervical tumors and construct a clinical prediction model to assess the prognosis of patients with PCL. Patients with PCL from the Surveillance, Epidemiology, and End Results database were allocated randomly in a 7:3 ratio to the training and validation sets. Cox proportional hazard and Fine-Gray models were used to verify independent factors influencing overall survival (OS) and disease-specific survival (DSS), and nomograms were constructed. Receiver operating characteristic curve analysis and decision curve analysis (DCA) were used to test the performance and clinical utility of the models, respectively. We included 206 patients with PCL. The areas under the curves (AUCs) and DCA showed that all models had clinical benefits; The models constructed in this study had a predictive performance for patients with PCL. It can guide clinicians to rationalize the treatment plan for patients.
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Affiliation(s)
- Wenjuan Fan
- Department of Gynecology, Xian No. 1 Hospital, Xi'an, China
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shiwei Sun
- Department of Urology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, China
| | - Jie Wang
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - You Lv
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Chen
- Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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3
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Lin C, Kuma L, Shen L. High-grade B-cell lymphoma with MYC and BCL2 rearrangements presenting as a cervical mass. Pathology 2024; 56:588-590. [PMID: 37940480 DOI: 10.1016/j.pathol.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/31/2023] [Accepted: 08/17/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Chiao Lin
- Pathology Queensland, Department of Anatomical Pathology, Townsville University Hospital, Townsville, Qld, Australia.
| | - Leslie Kuma
- Pathology Queensland, Department of Anatomical Pathology, Townsville University Hospital, Townsville, Qld, Australia
| | - Linda Shen
- Pathology Queensland, Department of Anatomical Pathology, Princess Alexandra Hospital, Brisbane, Qld, Australia
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4
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Mingola P, Alshomrani A, Greiner T. Anaplastic large cell lymphoma presenting as a mass in the uterine cervix: a case report. J Hematop 2024; 17:23-26. [PMID: 38376721 DOI: 10.1007/s12308-023-00568-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/20/2023] [Indexed: 02/21/2024] Open
Abstract
T-cell lymphoma is an extremely rare form of malignancy in the female genital tract. Most of the reported cases of lymphoma are B-cell lymphomas. A few cases of primary T-cell lymphomas involving the vagina or the vulva have been reported. We are reporting the first case of anaplastic large cell lymphoma (ALCL) presenting as a uterine cervical mass. The patient is a 24-year-old female who presented to the emergency room with a history of menorrhagia, night sweats and 40-pound weight loss. The diagnosis of ALCL was confirmed through immunohistochemical studies with strong CD30 and ALK expression. Fluorescent hybridization showed a rearrangement of the anaplastic lymphoma kinase (ALK) gene. Since ALCL may have a variable expression of T-cell antigens, the diagnosis may easily be missed when CD45 and/or CD3 is negative, and screening epithelial stains for carcinoma (e.g., p63 and EMA) are positive. CD30 must be performed to raise the consideration of ALCL when reniform nuclei are observed.
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Affiliation(s)
- Phillip Mingola
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ahmad Alshomrani
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Timothy Greiner
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
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5
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Ohlsen TJD, Morse RJ, Ahmad H, Pacheco MC, Debiec KE, Bohling SD. An Unusual Case of Extranodal Marginal Zone Lymphoma Mimicking Abdominal Cocoon Syndrome in an Adolescent Patient. Pediatr Dev Pathol 2024; 27:96-101. [PMID: 37903152 DOI: 10.1177/10935266231205511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is an indolent non-Hodgkin lymphoma rarely seen in pediatric patients. MALT lymphoma most commonly involves the gastrointestinal tract or peri-orbital tissues, potentially as sequela of chronic antigenic stimulation or immune dysregulation. Rare cases of MALT lymphoma arising from the gynecologic tract have been reported in older adult patients. We present the unique case of a 16-year-old postpubescent female with MALT lymphoma localized to the gynecologic tract, who initially presented with abdominal fullness, abnormal uterine bleeding, and obstructive acute kidney injury secondary to urinary outflow obstruction. Intraoperatively, dense fibrosis of the uterus and left fallopian tube was noted which mimicked abdominal cocoon syndrome. She was treated with 6 cycles of bendamustine and rituximab with complete anatomic and metabolic remission. In this report we highlight a very unusual presentation of a rare malignancy in the pediatric population as well as unique treatment considerations given this patient's young age and tumor location.
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Affiliation(s)
- Timothy J D Ohlsen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, Division of Hematology/Oncology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Ryan J Morse
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Hira Ahmad
- Department of General Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Maria Cristina Pacheco
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Katherine E Debiec
- Department of Pediatric Gynecology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Sandra D Bohling
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
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6
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Cury-Martins J, Giannotti MA, Miyashiro D, Pereira J, Sanches JA. A unique case of a lymphoproliferative disorder affecting the skin and uterine cervix on a male transgender. An Bras Dermatol 2024; 99:135-139. [PMID: 37661464 DOI: 10.1016/j.abd.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Jade Cury-Martins
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | - Denis Miyashiro
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana Pereira
- Department of Hematology, Universidade de São Paulo, São Paulo, SP, Brazil
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7
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Parkash V, Aisagbonhi O, Riddle N, Siddon A, Panse G, Fadare O. Recent Advances in the Classification of Gynecological Tract Tumors: Updates From the 5th Edition of the World Health Organization "Blue Book". Arch Pathol Lab Med 2023; 147:1204-1216. [PMID: 36596270 DOI: 10.5858/arpa.2022-0166-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 01/04/2023]
Abstract
CONTEXT.— The World Health Organization Classification of Tumours: Female Genital Tract Tumors, 5th edition, published in September 2020, comes 6 years after the 4th edition, and reflects the monumental leaps made in knowledge about the biology of gynecological tumors. Major changes include revised criteria for the assignment of the site of origin of ovarian and fallopian tube tumors, a revision in the classification of squamous and glandular lesions of the lower genital tract based on human papillomavirus association, and an entire chapter devoted to genetic tumor syndromes. This article highlights the changes in the 5th edition relative to the 4th edition, with a focus on areas of value to routine clinical practice. OBJECTIVE.— To provide a comprehensive update on the World Health Organization classification of gynecological tumors, highlighting in particular updated diagnostic criteria and terminology. DATA SOURCES.— The 4th and 5th editions of the World Health Organization Classification of Tumours. CONCLUSIONS.— The World Health Organization has made several changes in the 5th edition of the update on female genital tumors. Awareness of the changes is needed for pathologists' translation into contemporary practice.
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Affiliation(s)
- Vinita Parkash
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Omonigho Aisagbonhi
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
| | - Nicole Riddle
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Alexa Siddon
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- Department of Laboratory Medicine (Siddon), Yale University School of Medicine, New Haven, Connecticut
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Gauri Panse
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- The Department of Dermatology (Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Oluwole Fadare
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
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8
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Stabile G, Ripepi C, Sancin L, Restaino S, Mangino FP, Nappi L, Ricci G. Management of Primary Uterine Cervix B-Cell Lymphoma Stage IE and Fertility Sparing Outcome: A Systematic Review of the Literature. Cancers (Basel) 2023; 15:3679. [PMID: 37509340 PMCID: PMC10377927 DOI: 10.3390/cancers15143679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The female genital tract can be involved as a secondary manifestation of disseminated lymphomas or leukaemia but can rarely be the primary site of so-called extranodal lymphomas. Primary lymphomas of the female genital tract can affect the uterine corpus, uterine cervix, vulva, vagina, or adnexa. Only about 0.008% of all cervical tumours are primary malignant lymphomas. The most common clinical presentation of primary cervical lymphomas is a history of prolonged minor abnormal uterine bleeding, while unstoppable bleeding at presentation is rarely reported in the literature. "B" symptoms related to nodal lymphomas are usually absent. Since vaginal bleeding is a nonspecific symptom, the first diagnostic hypothesis is usually of one of the more common female genital conditions such as cervical or endometrial carcinoma or sarcoma, fibroids, adenomyosis, or endometriosis. Cervical cytology is usually negative. Preoperative diagnosis requires deep cervical biopsy. No guidelines regarding optimal treatment exists; radiotherapy, chemotherapy, and surgery are used in different combinations. Conservative treatment with the combination of surgery and chemotherapy or surgery and radiotherapy has been reported in a few cases with apparent success. With this review, we aim to understand what the best therapeutic approaches for this rare pathology in young and elderly women are. Moreover, we find favorable pregnancy outcome in patients treated with a fertility sparing approach.
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Affiliation(s)
- Guglielmo Stabile
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
| | - Chiara Ripepi
- UCO Clinica Ostetrica e Ginecologica, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Lara Sancin
- UCO Clinica Ostetrica e Ginecologica, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Stefano Restaino
- Obstetrics and Gynecology Unit, Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Udine University Hospital, 33100 Udine, Italy
| | - Francesco Paolo Mangino
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
| | - Luigi Nappi
- Departments of Obstetrics and Gynecology and Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy
- UCO Clinica Ostetrica e Ginecologica, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
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9
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Zhang Z, Yang Q. Primary diffuse large B-cell tumor of the uterus: a case report. Front Med (Lausanne) 2023; 10:1234861. [PMID: 37521344 PMCID: PMC10373583 DOI: 10.3389/fmed.2023.1234861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Primary diffuse large B-cell tumor of the uterus is a rare clinical condition with a similar clinical presentation to gynecologic tumors and is easily misdiagnosed. We report a case of a postmenopausal woman who presented with pelvic mass. Her ultrasound and MRI examinations suggested diffuse enlargement of the uterus, leading us to consider the diagnosis of lymphoma. The histological examination of the uterine mass confirmed the diagnosis of diffuse large B-cell lymphoma. The patient received 6 cycles of chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) and 2 cycles of consolidation therapy with R (rituximab). After treatment, the patient's uterus was significantly smaller than before and there was no sign of a recurrence.
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10
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Robles Díaz J. Manejo conservador con radioterapia e inmunoquimioterapia en el linfoma difuso de células B grandes primario de cuello uterino: Diagnóstico y tratamiento de una entidad rara. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2023. [DOI: 10.1016/j.gine.2023.100857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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11
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Zhang Y, Wang W, Chen T. Double‑hit primary lymphoma (MYC and BCL2) in the bilateral ovary: A case report. Oncol Lett 2023; 25:141. [PMID: 36909376 PMCID: PMC9996603 DOI: 10.3892/ol.2023.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
Lymphoid neoplasm with 18q21.3/BCL2 and 8q24/MYC translocation to immunoglobulin genes as dual-hit lymphoma in female bilateral ovaries is rare and has a poor clinical outcome. The present study reported on the case of a 33-year-old female, who was admitted to the hospital due to lower abdominal distension aggravated during defecation but with no obvious inducement. The B-ultrasound revealed bilateral adnexal solid masses and the pathological examination indicated advanced B-cell lymphoma (HGBL) with MYC and BCL2 gene rearrangement. The patient then received R-CHOP treatment, but the effects were poor. Rare extranodal HGBL presentations with MYC and BCL2 rearrangement should be considered in the differential diagnosis of masses at unusual sites, such as the adnexa. Due to their aggressive nature, early and prompt recognition of these lymphomas is essential for appropriately administering therapies.
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Affiliation(s)
- Yan Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Wei Wang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Tingting Chen
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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12
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Gao YF, Wang Y, Wang T, Han LN, Zhang H. A rare case report of primary uterine and vaginal lymphoma in the elderly. J Int Med Res 2023; 51:3000605221147192. [PMID: 36861225 PMCID: PMC9983095 DOI: 10.1177/03000605221147192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Uterine lymphoma is rare and usually occurs in middle-aged women. The clinical symptoms lack any specific characteristics. Imaging characteristics usually include uterine enlargement with density and uniform signal soft tissue masses. Magnetic resonance T2 weighted imaging, enhanced scanning, diffusion weighted imaging and apparent diffusion coefficient values have certain characteristics. The gold standard for diagnosis remains a pathological examination of a biopsy specimen. The special feature of this current case was that the uterine lymphoma occurred in an 83-year-old female patient that presented with a pelvic mass for more than 1 month. Based on the imaging findings, a primary uterine lymphoma was considered, but her advanced age of onset did not match the disease. After pathological confirmation, the patient was diagnosed with uterine lymphoma and she received eight cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) plus local radiotherapy for the large masses. The patients achieved good results. Follow-up enhanced computed tomography imaging showed that the uterine volume had significantly reduced compared with before treatment. The diagnosis of elderly patients with uterine lymphoma can provide a more accurate plan for subsequent treatment.
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Affiliation(s)
- Yu-Fei Gao
- Department of Radiology, The First Hospital of Hebei Medical
University, Shijiazhuang, Hebei Province, China
| | - Yong Wang
- Department of Radiology, The First Hospital of Hebei Medical
University, Shijiazhuang, Hebei Province, China
| | - Tao Wang
- Department of Endocrinology, The First Hospital of Hebei Medical
University, Shijiazhuang, Hebei Province, China
| | - Li-Na Han
- Department of Neurology, Hebei General Hospital, Shijiazhuang,
Hebei Province, China
| | - Hui Zhang
- Department of Radiology, The First Hospital of Hebei Medical
University, Shijiazhuang, Hebei Province, China,Hui Zhang, Department of Radiology, Hebei
General Hospital, 348 Heping West Road, Xinhua District, Shijiazhuang, Hebei
050051, China.
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13
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Wong J, Roy SF, Provencher D, Maietta A, Rahimi K. Leiomyoma With Massive Lymphoid Infiltration: 2 Cases With Lymphocytic Vasculopathy and Angiocentric Germinal Centers. Int J Gynecol Pathol 2023; 42:155-158. [PMID: 35348475 DOI: 10.1097/pgp.0000000000000881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Uterine leiomyoma with massive lymphoid infiltration is characterized by a dense lymphoid infiltrate and germinal centers sparing the adjacent myometrium. Only few reports describe this entity and its etiology is unknown. This rare lesion may also exhibit lymphocytic vasculopathy but this has only been reported in the setting of GnRH agonist exposure. We report 2 cases of uterine leiomyoma with massive lymphoid infiltration in which only 1 patient was exposed to GnRH agonists. In both cases, histopathologic analysis showed thick-walled vessels with swollen endothelial cells showing evidence of intramural lymphocytic infiltration, red blood cell extravasation, and medial edema. This constellation of findings represented frank vascular damage and lymphocytic vasculopathy. Our findings suggest that lymphocytic vasculopathy in these lesions may be secondary to factors other than GnRH agonists. Furthermore, both cases showed an angiocentric disposition of germinal centers that has scarcely been alluded to in prior reports. This finding may provide a clue in accurately recognizing leiomyoma with massive lymphoid infiltration. Recognition of this lesion will allow one to avoid mistaking it for mimickers such as inflammatory myofibroblastic tumor, lymphoid malignancies, or other inflammatory processes.
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14
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Weng X, Huang M, Zhang M, Yang Y, Liu X, Huang Y. Primary lymphoma of the uterine cervix: a clinicopathologic study of 13 cases with review of additional 54 cases in the literature. Virchows Arch 2023; 482:419-429. [PMID: 36350409 DOI: 10.1007/s00428-022-03436-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
Primary lymphoma of the uterine cervix (LUCX) is extremely rare, and its diagnosis is challenging. However, its clinicopathological features have not been well characterized. Thirteen primary LUCX patients were retrospectively studied, and 54 patients from the literature were reviewed. Primary LUCX was identified in 0.22% (13/6000) of patients with uterine cervical malignancies in our institution. The patients' median age was 51 years (range: 22-85 years). All patients had a bulk of neoplasms in the uterine cervix. The median tumour diameter was 6 cm (range: 1.5-10 cm). Approximately 78.0% (39/50) of the patients initially presented with irregular vaginal bleeding or discharge. Moreover, 86.7% (39/45) had Ann Arbor stage I or II. Diffuse large B-cell lymphoma, not otherwise specified, was the most common type, accounting for 85.0% (57/67) of primary LUCX cases. Follicular lymphoma (7.5%, 5/67), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (4.5%, 3/67), mantle cell lymphoma (MCL), blastoid variant (1.5%, 1/67), and peripheral T-cell lymphoma (1.5%, 1/67) were occasionally observed. Three patients (7.1%, 3/42) with DLBCL, NOS died from the disease during the follow-up period. Their 5-year overall survival (OS) rate was 93.5%. The patient with MCL, blastoid variant in our present cohort died of the disease 33 months after diagnosis. Primary LUCX is an extremely rare condition. The clinical symptoms are non-specific. DLBCL, NOS is the most common histologic type, showing a favourable outcome with accurate diagnosis and timely and optimal treatment.
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Affiliation(s)
- Xin Weng
- Department of Pathology, Shenzhen Second People's Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Mayan Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.,Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Meng Zhang
- Department of Pathology, Shenzhen Second People's Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Yajie Yang
- Department of Pathology, Shenzhen Second People's Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xia Liu
- Department of Pathology, Shenzhen Second People's Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Yuhua Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China. .,Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
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15
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Gao L, Chen X, Zhao J, Xu A, Liu M, Yu H, Kong S, Li S. Advanced Ann Arbor stage and age over 60 years as prognostic predictors in patients with primary cervical lymphoma: a retrospective cohort study and systematic review. BMC Cancer 2023; 23:95. [PMID: 36707772 PMCID: PMC9881271 DOI: 10.1186/s12885-023-10548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To evaluate the overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) for primary cervical lymphoma (PCL), an extremely rare disease without treatment consensus. METHODS We conducted a retrospective study included 177 patients, including 169 cases identified from literature review. The Kaplan-Meier methods and Cox regression were used to determine the OS, DSS, RFS, and relevant risk factors. RESULTS The 5-year OS and 5-year DSS rates were 85.8 and 87.2%, respectively, while the 5-year RFS rate was 85.5%. Diffuse large B-cell lymphoma (DLBCL) was the predominant subtype that comprised 63.8% (113 cases) in this cohort. Multivariate analysis in the DLBCL subgroup revealed that age ≥ 60 years (Odds ratio [OR]: 26.324, 95% Confidence Interval [CI]: 5.090-136.144, P < 0.001) or stage IIIE-IVE (advanced stage) (OR: 4.219, 95%CI: 1.314-13.551, P = 0.016) were the risk factors for OS, while patients with age ≥ 60 years (OR:23.015, 95%CI: 3.857-137.324, P = 0.001), and stage IIIE-IVE (OR: 4.056, 95% CI: 1.137-14.469, P = 0.031) suffered a poor DSS. Chemotherapy and/or radiotherapy improved the OS (P = 0.008), DSS (P = 0.049), and RFS (P = 0.003). However, cancer-directed surgery did not improve the OS, DSS, and RFS. The risk factor was unavailable in other subtypes of PCL due to limited cases. CONCLUSION The survival outcomes in patients with PCL at early stage were satisfactory, while the advanced disease stage and age ≥ 60 years were the two major factors predicting poor prognosis in DLBCL subtype.
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Affiliation(s)
- Lingyun Gao
- grid.440323.20000 0004 1757 3171Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Xiaoran Chen
- grid.440323.20000 0004 1757 3171Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Jing Zhao
- grid.440323.20000 0004 1757 3171Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Anli Xu
- grid.440323.20000 0004 1757 3171Department of Obstetrics and Gynecology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Meijuan Liu
- grid.440323.20000 0004 1757 3171Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Hongna Yu
- grid.440323.20000 0004 1757 3171Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Shujun Kong
- grid.440323.20000 0004 1757 3171Department of Obstetrics and Gynecology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong People’s Republic of China
| | - Sijian Li
- grid.413106.10000 0000 9889 6335Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
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Kalloli M, Patil H, Dhamankar S, Desai K, Sanikop A, Bhise R, Ghei P. Plasmablastic Lymphoma of the Endometrium: A Rare Site for Primary Presentation. J Obstet Gynaecol India 2022; 72:454-457. [PMID: 36458059 PMCID: PMC9568635 DOI: 10.1007/s13224-021-01550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/11/2021] [Indexed: 10/18/2022] Open
Abstract
Global incidence of non-Hodgkin's lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma. Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B-cell lymphoma (DLBCL). It is usually seen in human immunodeficiency virus (HIV) infected patients. PBL occurring in extranodal site, particularly female genital tract, is very rare, and only few case reports have been reported. Here, we report a unique rare case of uterine PBL in an HIV/Epstein-Barr virus-negative patient that was initially diagnosed as endometrioid carcinoma.
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Affiliation(s)
- Mahesh Kalloli
- Department of Surgical Oncology, Jawahar Nehru Medical College, Belgaum, India
| | - Hema Patil
- Department of OBG, Jawahar Nehru Medical College, Belgaum, India
| | | | | | - Adarsh Sanikop
- Department of Pathology, Jawahar Nehru Medical College, Belgaum, India
| | - Rohan Bhise
- Department of Medical Oncology, Jawahar Nehru Medical College, Belgaum, India
| | - Prem Ghei
- Department of General Surgery, Jawahar Nehru Medical College, Belgaum, India
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17
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Li J, Zhang X, Liu Y, Li Q, Guo Y, Yu H. Primary diffuse large B-Cell lymphoma of the uterine cervix with severe lower urinary tract Symptoms: A rare case report and review of the literature. Gynecol Oncol Rep 2022; 43:101066. [PMID: 36110368 PMCID: PMC9467866 DOI: 10.1016/j.gore.2022.101066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jiaosheng Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510168, China
| | - Xiufen Zhang
- Department of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya 572013, China
| | - You Liu
- Department of Pathology, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Qinhua Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510168, China
| | - Yifan Guo
- Department of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya 572013, China
- Corresponding authors at: Department of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya 572013, China (G. Yifan) Department of Obstetrics and Gynecology, The Eighth Medical Center of PLA General Hospital, Beijing 100094, China (Y. Haotian).
| | - Haotian Yu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510168, China
- Department of Obstetrics and Gynecology, The Eighth Medical Center of PLA General Hospital, Beijing 100094, China
- Corresponding authors at: Department of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya 572013, China (G. Yifan) Department of Obstetrics and Gynecology, The Eighth Medical Center of PLA General Hospital, Beijing 100094, China (Y. Haotian).
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18
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Stabile G, Sancin L, Boschian Bailo P, Ripepi C, Romano A, Carlucci S, Ricci G. Hysteroscopic Resection Followed by Adjuvant Radiotherapy: Report of a New Therapeutic Approach to Primary Cervical Diffuse Large B-Cell Lymphoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11779. [PMID: 36142052 PMCID: PMC9517014 DOI: 10.3390/ijerph191811779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
The female genital tract can be involved as a secondary manifestation of disseminated lymphomas or leukemia but can rarely be the primary site of so-called extranodal lymphomas. Primary lymphomas of the female genital tract can affect the uterine corpus, uterine cervix, vulva, vagina or adnexa. Only about 0.008% of all cervical tumors are primary malignant lymphomas. The presenting symptoms are unspecific and also refer to much more common diseases of the female genital tract. Cervical cytology is usually negative. Preoperative diagnosis requires deep cervical biopsy. To date there is no consensus regarding optimal treatment. Radiotherapy, chemotherapy and surgery are used in different association. We report the first case reported in literature managed with an urgent hysteroscopic resection of a primary cervical diffuse large B-cell lymphoma, followed by adjuvant radiotherapy. Relevant literature was reviewed. Our conservative approach needs to be validated in the future, especially for women with pregnancy desire and for those with low performance status. To date, after 24 months from diagnosis, our patient is still disease-free.
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Affiliation(s)
- Guglielmo Stabile
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Department of Obstetrics and Gynaecology, 34137 Trieste, Italy
| | - Lara Sancin
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
| | - Pierino Boschian Bailo
- Department of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Giuliano-Isontina, San Polo Hospital, Gorizia-Monfalcone, 34149 Trieste, Italy
| | - Chiara Ripepi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
| | - Andrea Romano
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
| | - Stefania Carlucci
- Department of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Giuliano-Isontina, San Polo Hospital, Gorizia-Monfalcone, 34149 Trieste, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Department of Obstetrics and Gynaecology, 34137 Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
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19
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Ji M, Jin Y, Chen X, Li Y, Rahman J, Dai H. Primary mucosa-associated lymphoid tissue lymphoma in fallopian tubes: A case report and literature review. Medicine (Baltimore) 2022; 101:e30228. [PMID: 36042662 PMCID: PMC9410653 DOI: 10.1097/md.0000000000030228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 7%-8% of newly diagnosed lymphomas. The stomach is the most common organ of origin (nearly 50% of MALT lymphomas). Only 2% of MALT lymphomas arise from the female genital tract, and most originated from uterus. We described a rare case of MALT lymphoma primarily arising from the fallopian tube. PATIENT CONCERNS A 26-year-old woman was brought into our gynecological clinic because of a history of irregular menstruation. The transvaginal ultrasonography revealed cystic masses in bilateral adnexa and both of them showed rich vasculature. Laboratory tests showed a high level (455.3 U/mL) of cancer antigen-125 (CA-125). INTERVENTIONS A laparoscopy was performed. OUTCOMES Frozen section of the removed specimen revealed acute and chronic inflammation with abundant inflammatory cells infiltrating the mesenchyme. The right fallopian tube was removed. However, the final histological results showed inflammation accompanied by hyperplasia of lymphoid tissue. Immunohistochemistry staining were consistent with MALT lymphoma. The patient received the second surgery to remove the left fallopian tube and also confirmed the same pathology. LESSONS Gynecologists should be aware of cystic masses which showed rich vasculature and high level of CA-125.
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Affiliation(s)
- Mengying Ji
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yichao Jin
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xing Chen
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yujing Li
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Juveria Rahman
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Huihua Dai
- Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- * Correspondence: Huihua Dai, PhD, Department of Gynecology, The First Affiliated Hospital with Nanjing Medical University, 368 Jiangdong North Road, Gulou, Nanjing, China. (e-mail: )
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20
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Khdhir M, El Annan T, El Amine MA, Shareef M. Complications of lymphoma in the abdomen and pelvis: clinical and imaging review. Abdom Radiol (NY) 2022; 47:2937-2955. [PMID: 35690955 PMCID: PMC10509750 DOI: 10.1007/s00261-022-03567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023]
Abstract
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
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Affiliation(s)
- Mihran Khdhir
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
| | - Tamara El Annan
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon
| | | | - Muhammed Shareef
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, CT, USA
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21
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Aminimoghaddam S, Salarifar E, Noei Teymoordash S. Primary large B‐cell lymphoma of the cervix: A case report and review of literature. Clin Case Rep 2022; 10:e05639. [PMID: 35356182 PMCID: PMC8955961 DOI: 10.1002/ccr3.5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 12/02/2022] Open
Abstract
The primary diffuse large B‐cell lymphoma (DLBCL) of the uterine cervix is extremely rare. In the present study, we described two cases of DLBCL of the uterine cervix in reproductive‐aged women complaining of postcoital bleeding, recurrent vaginal discharge, and abnormal uterine bleeding.
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Affiliation(s)
- Soheila Aminimoghaddam
- Department of Obstetrics and Gynecology Faculty of Medicine Iran University of Medical Sciences Tehran Iran
| | - Elnaz Salarifar
- Department of Obstetrics and Gynecology Faculty of Medicine Iran University of Medical Sciences Tehran Iran
| | - Somayyeh Noei Teymoordash
- Department of Obstetrics and Gynecology Faculty of Medicine Iran University of Medical Sciences Tehran Iran
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22
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Hamer J, Alazizi M, Tahmasebi F. An Unusual Case of Chronic Lymphocytic Leukaemia Involving the Cervix. Cureus 2022; 14:e21823. [PMID: 35291544 PMCID: PMC8896842 DOI: 10.7759/cureus.21823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is a malignant monoclonal expansion of B lymphocytes, with accumulation of abnormal lymphocytes in the blood, bone marrow, spleen, lymph nodes and liver. It is mainly a disease of the elderly population. Though extra-nodal involvement is common, cervical and vulvovaginal involvement by CLL is particularly uncommon. In this case report, we discuss the case of cervical involvement of CLL in an 84-year-old patient who presented to rapid-access gynaecological clinic following concerns of persistent postmenopausal bleeding. Previously the patient was known to haematology with a well-controlled diagnosis of CLL since 2007. The initial examination was significant for an enlarged, irregular cervix, whereby a punch biopsy was then obtained. Histological analysis revealed evidence of CLL within the cervix.
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23
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Albuquerque KS, Zoghbi KK, Gomes NBN, Libânio BB, Souza e Silva TX, de Araújo EM, Lewin F, Pedroso MHNI, Torres US, D'Ippolito G, Racy DJ, Bernardo GCO. Vaginal cancer: Why should we care? Anatomy, staging and in-depth imaging-based review of vaginal malignancies focusing on MRI and PET/CT. Clin Imaging 2022; 84:65-78. [DOI: 10.1016/j.clinimag.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 11/03/2022]
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Primary Non-Hodgkin Uterine Lymphoma of the Cervix: A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010106. [PMID: 35056415 PMCID: PMC8780590 DOI: 10.3390/medicina58010106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 12/26/2022]
Abstract
Introduction: Non-Hodgkin lymphomas (NHL) comprise 85% of the total lymphomas diagnosed, with the histological type of diffuse large B-cell lymphomas (DLBCL) being the most prevalent in adults. In about 40% of cases, the location is extranodal. Uterine cervix lymphomas of this type are extremely rare (0.5–1.5%) and represent a diagnostic challenge. A case of DLBCL of the cervix is presented here along with a review of the literature. Materials and methods: A 75-year-old patient was referred with a bleeding vegetant tumour occupying her entire vagina. The histological and pathological investigations performed following the tumour biopsy indicated a malignant, diffuse, vaguely nodular lymphoid tumour proliferation. The immunohistochemistry results were in favour of a diffuse B-cell non-Hodgkin lymphoma (DLBCL). CHOP (Cyclophosphamide, Hydroxydaunorubicin (also called doxorubicin or adriamycin), Oncovin (vincristine), Prednisone or Prednisolone) polychemotherapy and radiotherapy were effective and resulted in tumour regression (from 3.4 cm to tumour disappearance, with the cervix returning to normal size). Conclusions: The uterine cervix lymphoma prognosis is more conservative than that for a nodal lymphoma, mainly due to a later diagnosis determined via immunohistochemistry. Chemotherapy is the main treatment.
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25
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Du E, Qu X, Xu W, Lu H. Primary female genital system lymphoma complicated by a recurrent mucinous borderline ovarian tumor: a case report and review of the literature. BMC Womens Health 2021; 21:420. [PMID: 34922516 PMCID: PMC8684173 DOI: 10.1186/s12905-021-01568-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background Primary female genital system lymphoma (PFGSL) is an infrequent entity. All genital organs may be affected, and most PFGSLs are localized to the cervix, uterine body, and ovaries. The clinical manifestations are nonspecific, which complicates a timely diagnosis. We report an unexpected case of PFGSL and discuss the disease characteristics by reviewing the literature. Case presentation A 48-year-old G3/P2 woman presented to the Department of Gynecology with a physical examination. Ultrasound examination and CT revealed pelvic masses. The woman underwent surgical treatment because of the pelvic masses and underwent a hysterectomy for a recurrent mucinous borderline ovarian tumor. However, the results of the postoperative pathological examination showed diffuse large B-cell lymphoma of the endometrium. After four courses of chemotherapy, the woman was in good condition. The clinical manifestations were nonspecific, which made a timely diagnosis complex. Conclusion This case highlights the importance of the difficulty in detecting early PFGSL early and how easily nonspecific manifestations can be ignored. It may lead to missing the best time for early treatment.
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26
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Ensor AM, Sanchez CG, Ensor JE, Anand K. Primary diffuse large B-cell lymphoma of the uterus: A SEER database analysis. Medicine (Baltimore) 2021; 100:e27359. [PMID: 34622835 PMCID: PMC8500583 DOI: 10.1097/md.0000000000027359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Uterine diffuse large B-cell lymphoma (DLBCL) is a rare clinical condition. Most studies for uterine DLBCL are derived from case reports and series. Our main objective was to present a new case while also investigating the demographic, clinical characteristics, and survival of women with primary uterine DLBCL as compared to non-uterine DLBCL using the Surveillance, Epidemiology, and End Results incidence database. We queried the Surveillance, Epidemiology, and End Results database for women aged 18 years or older with a diagnosis of primary DLBCL from 1975 to 2017. The most common site of primary uterine DLBCL is the cervix uteri not otherwise specified, followed by endometrium, uterus not otherwise specified, corpus uteri, myometrium and isthmus uteri. Non-uterine DLBCL cases tend to be older than uterine DLBCL cases. Uterine DLBCL is most common among women aged 40 to 64 years. Patients with uterine DLBCL showed greater survival than non-uterine DLBCL patients, and patients treated in the rituximab era also exhibited a survival benefit. Both the elderly and African American cohorts experienced worse overall survival.
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Affiliation(s)
- Allyne M. Ensor
- William Carey University College of Medicine, Hattiesburg, MS
| | | | - Joe E. Ensor
- Houston Methodist Cancer Center, Houston, TX
- Houston Methodist Research Institute, Houston, TX
| | - Kartik Anand
- Callahan Cancer Center, Great Plains Health, North Platte, NE
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27
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Rastegar S, Heller DS. Nonsquamous Lesions of the Vulvar Skin and Subcutaneous Tissue: A Review (Part 1). J Low Genit Tract Dis 2021; 25:303-311. [PMID: 34542086 DOI: 10.1097/lgt.0000000000000624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This article aimed to review "nonsquamous lesions of the vulvar skin and subcutaneous tissue" clinically and pathologically, based on the fifth edition of the World Health Organization tumor classification. MATERIALS AND METHODS A database search of PubMed and Google Scholar was performed between 1970 and 2021, using the search terms "vulva," "lower genital tract," and "nonsquamous lesions." The search was limited to "humans," "gynecopathology," and "dermatopathology." Full article texts were reviewed. Reference lists were screened for additional articles. We excluded articles written in the non-English language and abstracts. RESULTS A list of 600 articles was identified. Another screening identified 68 articles for clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue. In the first part of this review, we cover 5 major groups of nonsquamous lesions of the vulvar skin and subcutaneous tissue including (1) glandular tumors and cysts, (2) adenocarcinomas of other types, (3) germ cell tumors of the vulva, (4) neuroendocrine neoplasia, and (5) hematolymphoid hyperplasia and neoplasia. The rest of the major topics including mesenchymal tumors of the lower genital tract, melanocytic lesions, and metastasis will be discussed in the second part of this review. CONCLUSIONS Clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue as categorized by the updated World Health Organization classification are presented.
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Affiliation(s)
- Shima Rastegar
- Department of Pathology, Immunology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ
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28
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Pintican R, Bura V, Zerunian M, Smith J, Addley H, Freeman S, Caruso D, Laghi A, Sala E, Jimenez-Linan M. MRI of the endometrium - from normal appearances to rare pathology. Br J Radiol 2021; 94:20201347. [PMID: 34233457 DOI: 10.1259/bjr.20201347] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
MRI was recently included as a standard pre-operative diagnostic tool for patients with endometrial cancer. MR findings allow a better risk assessment and ultimately guides the surgical planning. Therefore, it is vital that the radiological interpretation is as accurate as possible. This requires essential knowledge regarding the appropriate MRI protocol, as well as different appearances of the endometrium, ranging from normal peri- and post-menopausal changes, benign findings (e.g. endometrial hyperplasia, polyp, changes due to exogenous hormones) to common and rare endometrium-related malignancies. Furthermore, this review will emphasize the role of MRI in staging endometrial cancer patients and highlight pitfalls that could result in the underestimation or overestimation of the disease extent.
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Affiliation(s)
- Roxana Pintican
- "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca,Romania; County Clinical Emergency Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Vlad Bura
- County Clinical Emergency Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Marta Zerunian
- Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Janette Smith
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Helen Addley
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Susan Freeman
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Damiano Caruso
- Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Andrea Laghi
- Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Evis Sala
- Department of Radiology and CRUK Cambridge Center, Cambridge Biomedical Campus, Cambridge, UK
| | - Mercedes Jimenez-Linan
- Department of Histopathology, Cambridge University Hospital NHS foundation Trust, Cambridge, UK
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Zhou Y, Zhang C, Gong Y, Yang L, Wang Y. Primary diffuse large B-cell lymphoma of the fallopian tube treated with a combination of surgery and chemotherapy: Case report. Medicine (Baltimore) 2021; 100:e24049. [PMID: 33546005 PMCID: PMC7837899 DOI: 10.1097/md.0000000000024049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Primary female genital tract lymphomas are sporadic neoplasms, accounting for 0.2% to 1.1% of all cases of extranodal lymphoma. The most common genital localizations are the cervix, the uterine corpus and the ovary, while primary lymphomas of the fallopian tube are quite unusual. According to literature searching in PubMed, this is the first reported case of primary diffuse large B-cell lymphoma of the fallopian tube. PATIENT CONCERNS A 52-year-old woman presented with a more than 2 months history of intermittent lower abdominal pain. The gynecological examination showed that the uterus, as big as 3 months of pregnancy, had weak activity and no tenderness. The uterine rectum lacuna was like a hard nodule of about 3 × 2 cm, and an irregular solid mass was fixed and inactive in the right adnexa. DIAGNOSES In accordance with Ann Arbor staging system, a stage IE primary diffuse large B-cell lymphoma of fallopian tube was diagnosed for this patient, based on the tumor pathology, the results of bone marrow biopsy and computed tomography (CT) scan. INTERVENTIONS After gynecological/urinary ultrasound, blood test, pelvic contrast enhanced CT scan and CT angiography of iliac artery, exploratory laparoscopy and following hysterectomy with bilateral salpingo-oophorectomy were performed. After the surgery, the patient was treated with combined Rituximab and chemotherapy and got complete response (CR). OUTCOMES After the operation and R-CHPOP, following up for more than 1 year so far, the patient has no tumor recurrence and is still in good condition. LESSONS It is very difficult to diagnose the primary diffuse large B-cell lymphoma of fallopian tube, not only because of its rarity, but also because of its non-specific clinical manifestations. It easily be treated as late ovarian cancer by gynecologist. So the pathology diagnosis and surgeons' decision is very important. Because lymphoma is pretty sensitive to chemotherapy and easy to get complete response, so we no need to do an operation like ovarian cancer and should put chemotherapy as a primary method for lymphomas of the female genital tract.
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Affiliation(s)
- Ye Zhou
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Jining Medical University
| | - Chao Zhang
- School of Clinical Medicine Jining Medical University, Shandong, China
| | - Yingying Gong
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Jining Medical University
| | - Linqing Yang
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Jining Medical University
| | - Yunfei Wang
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Jining Medical University
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Yoshida Y, Izumi R, Iwashita S, Nakashima N, Kishida K, Imachi Y, Shimada Y, Maehara K, Wada T, Ando M, Hamasaki Y, Kurihara S, Onjo S, Nishida M. Malignant lymphoma of the cervix in a bicollis uterus considered to be a post-transplant lymphoproliferative disorder in a patient after renal transplantation: A case report. Gynecol Oncol Rep 2020; 34:100676. [PMID: 33304978 PMCID: PMC7718170 DOI: 10.1016/j.gore.2020.100676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/06/2020] [Accepted: 11/14/2020] [Indexed: 10/26/2022] Open
Abstract
Post-transplant lymphoproliferative disorder (PTLD) refers to a group of diseases, characterized by abnormal proliferation of lymphocytes, that develop after organ transplantation. PTLD is associated with poor prognosis, and has become a major problem for transplant patients. In this report, we described a case of malignant lymphoma of the cervix in a bicollis uterus considered to be a PTLD in a patient after renal transplantation. The incidence of this disease is expected to increase as the survival rate of transplant patients improves. Hence, it is very important for gynecological oncologists to consider the presence of PTLD when examining such patients.
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Affiliation(s)
- Yu Yoshida
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Ririko Izumi
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Saki Iwashita
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Natsumi Nakashima
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Kaori Kishida
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Yuzo Imachi
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Yukiyo Shimada
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Kana Maehara
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Tomoko Wada
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Mariko Ando
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Yoichiro Hamasaki
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Shuichi Kurihara
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Sachiko Onjo
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
| | - Makoto Nishida
- Department of Obstetrics and Gynecology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ohgusu, Minami-ku, Fukuoka 815-8555, Japan
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31
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Del M, Angeles MA, Syrykh C, Martínez-Gómez C, Martínez A, Ferron G, Gabiache E, Oberic L. Primary B-Cell lymphoma of the uterine cervix presenting with right ureter hydronephrosis: A case report. Gynecol Oncol Rep 2020; 34:100639. [PMID: 32995453 PMCID: PMC7508993 DOI: 10.1016/j.gore.2020.100639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 11/18/2022] Open
Abstract
Primary lymphoma of the uterine cervix is a very infrequent disease, usually affecting perimenopausal women. Symptoms are very similar to other gynecological malignancies, but treatment and prognosis completely differ, as most of these patients have a better survival. This condition has to be suspected in women with recent normal Pap smear test, rapidly growing tumor and initially non-contributory biopsies. We report a case of primary diffuse large-B-cell lymphoma of the uterine cervix mimicking a locally advanced cervical cancer with right ureter hydronephrosis at diagnosis. She was medically managed with a combination of rituximab and chemotherapy with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone, associated to methotrexate for central nervous system prophylaxis. We will discuss about the role of combined treatments with surgery and radiotherapy, and the fertility sparing management in young women.
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Affiliation(s)
- Mathilde Del
- Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
| | - Charlotte Syrykh
- Department of Pathology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
| | - Carlos Martínez-Gómez
- Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
- INSERM CRCT Team 1, Tumor Immunology and Immunotherapy, Toulouse, France
| | - Alejandra Martínez
- Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
- INSERM CRCT Team 1, Tumor Immunology and Immunotherapy, Toulouse, France
| | - Gwénaël Ferron
- Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
- INSERM CRCT Team 19, ONCOSARC – Oncogenesis of sarcomas, Toulouse, France
| | - Erwan Gabiache
- Department of Nuclear Medicine, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
| | - Lucie Oberic
- Department of Hematology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
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32
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Kumar S, Singhal S, Jayraj AS, Mallick S, Kaur K, Kumar L. Secondary Postpartum Haemorrhage: A Rare Presentation of Secondary Uterine Mantle Cell Lymphoma. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2020. [DOI: 10.1007/s40944-020-00440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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33
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Goda JS, Gaikwad U, Narayan A, Kurkure D, Yadav S, Khanna N, Jain H, Bagal B, Epari S, Singh P, Sengar M, Laskar S. Primary diffuse large B cell lymphoma of Uterine Cervix: Treatment outcomes of a rare entity with literature review. Cancer Rep (Hoboken) 2020; 3:e1264. [PMID: 32761885 DOI: 10.1002/cnr2.1264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Primary lymphomas involving the female genital tract are rare, and those arising from cervix are extremely uncommon. They are often misdiagnosed because of their rarity. METHODS AND CASES The treatment and clinical outcomes of the four cases treated at our institution were compared with the previously published studies. Written informed consent was taken. We highlight four cases of primary diffuse large B-cell lymphoma of cervix treated at our institution with immunochemotherapy and radiotherapy. The mean age was 50 years (range, 39-62 years). Three patients had stage I disease while one had stage II disease. All the patients were in complete remission following treatment with immunochemotherapy and radiation therapy. The average disease free survival was 20 months (range, 8-43 months). None of the patients had any local or systemic relapse. CONCLUSION These cases highlight the physicians to be aware of this entity as their management, natural history and prognosis is completely different from squamous carcinomas of the cervix. Surgery should not be attempted in these patients. Immunochemotherapy and radiotherapy results in favorable clinical outcomes.
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Affiliation(s)
- Jayant Sastri Goda
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Utpal Gaikwad
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Anand Narayan
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Durva Kurkure
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Subhash Yadav
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Nehal Khanna
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Hasmukh Jain
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Bhausaheb Bagal
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Sridhar Epari
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Priya Singh
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Manju Sengar
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - Siddharth Laskar
- Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
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34
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Pons L, Carballas E, Tapia G. Primary diffuse large B cell lymphoma of the cervix. Med Clin (Barc) 2020; 156:530-531. [PMID: 32439153 DOI: 10.1016/j.medcli.2020.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/02/2020] [Accepted: 02/06/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Laura Pons
- Servicio de Anatomía Patológica, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Elvira Carballas
- Servicio de Ginecología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Gustavo Tapia
- Servicio de Anatomía Patológica, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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35
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Shahid M, Schroeder M, Radigan K, Zamulko AO. Asymptomatic cervical stiffness as the sole presenting feature of ovarian follicular lymphoma: The value of hands-on medicine. J Family Med Prim Care 2020; 9:1260-1262. [PMID: 32318510 PMCID: PMC7114043 DOI: 10.4103/jfmpc.jfmpc_842_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 12/01/2022] Open
Abstract
A primary care visit is the first encounter of a patient with health care. In context to malignancies, breast cancer and primary ovarian lymphomas are NA clinically and morphologically different malignancies. The rare concurrence of breast cancer and non-Hodgkin lymphoma (NHL) does not warrant any routine surveillance through testing but we present a case of a 71-year-old female with the history of invasive ductal carcinoma of the breast in remission who was diagnosed with follicular carcinoma after an abnormal pelvic examination during her routine primary care visit. This highlights that a routine PC visit with a skilled physical examination can prove to be one of the most cost-effective tools for screening high-risk cancer patients in remission.
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Affiliation(s)
- Mahum Shahid
- PGY-2, Department of Internal Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota, USA
| | - Michael Schroeder
- MS-4, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota, USA
| | - Kathryn Radigan
- Sanford Women's Internal Medicine Clinic, Sioux Falls, South Dakota, USA
| | - Alla O Zamulko
- Department of Internal Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota, USA
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36
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Primary ovarian diffuse large B-cell lymphoma preceded by autoimmune hemolytic anemia. J Hematop 2019. [DOI: 10.1007/s12308-019-00377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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37
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Blastic variant of plasma cell myeloma mimicking squamous cell carcinoma of the uterine cervix in a super-morbidly obese female. Gynecol Oncol Rep 2019; 29:34-37. [PMID: 31249854 PMCID: PMC6586946 DOI: 10.1016/j.gore.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/29/2019] [Indexed: 11/20/2022] Open
Abstract
Plasmablastic plasma cell myelomas of the cervix can mimic the more common cervical squamous cell carcinoma. It can be difficult to differentiate plasmablastic lymphoma of the cervix from cervical plasmablastic plasma cell myeloma. The clinician must rely on clinical, laboratory, and radiologic findings to diagnose genital plasma cell myeloma. Prompt diagnosis of this rare clinical condition can potentially allow timely treatment with systemic chemotherapy.
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38
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Endometrial cancer arising after complete remission of uterine malignant lymphoma: A case report and mutation analysis. Gynecol Oncol Rep 2019; 28:50-53. [PMID: 30886885 PMCID: PMC6402229 DOI: 10.1016/j.gore.2019.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/15/2022] Open
Abstract
Uterine malignant lymphoma is rare and its association with secondary cancer has not been fully described. Here, we report a rare case of endometrial cancer arising after 1 year of complete remission of uterine diffuse large B-cell lymphoma (DLBCL). An 88-year-old woman was referred to us for abnormal genital bleeding and was diagnosed with uterine DLBCL. She underwent chemotherapy comprising rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisolone followed by radiation therapy; subsequently, she achieved complete remission. One year later, she noticed genital bleeding recurrence, and endometrial biopsy revealed endometrial adenocarcinoma. Total hysterectomy and bilateral salpingo-oophorectomy were performed. Her pathological diagnosis was endometrial endometrioid carcinoma, grade 1 (pT1aN0). Adenocarcinoma was observed over foamy macrophages aggregates, indicating remission of DLBCL. Targeted sequencing of both DLBCL and endometrial cancer revealed 24 gene mutations including the truncation-type mutations of ARID1A and PTEN occurring only in endometrial cancer. These multiple somatic gene mutations accumulating within 1 year imply endometrial carcinogenesis induced by DNA damages caused by treatment for DLBCL. Although the epidemiological risk of secondary malignancies after uterine lymphoma remains unclear, the present case serves as a warning for secondary cancer and highlights the importance of early detection and treatment.
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39
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Primary extranodal lymphoma of the glands. Literature review and options for best practice in 2019. Crit Rev Oncol Hematol 2019; 135:8-19. [PMID: 30819450 DOI: 10.1016/j.critrevonc.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 12/04/2018] [Accepted: 01/15/2019] [Indexed: 01/01/2023] Open
Abstract
Primary extranodal non-Hodgkin's lymphomas (EN-NHL) are a heterogeneous group of malignancies that involve numerous entities with significant difference in terms of tumor site locations, prognostic factors, biology expression, and therapeutic options. In the literature, many EN-NHL types were reported from limited series which only allowed narrow views for elucidating prognostic factors and defining the role of loco-regional therapies in the era of new systemic and biologically targeted therapies. The Rare Cancer Network (RCN), an international multidisciplinary consortium, has published a number of reports on several EN-NHL sites which included many gland locations. In this review, we will focus on the recent literature for a selected number of EN-NHL types in both exocrine and endocrine gland locations. We aim to provide renewed and clear messages for the best practice in 2019 for diagnosis, histopathology, treatments, and also their prognostic implications. We believe that better understanding of molecular and genetic characteristics of these particular diseases is crucial for an appropriate management in the era of personalized treatment developments.
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40
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A Case of Primary Uterina Lymphoma Presenting with Bleeding, Pelvic Pain, and Dysmenorrhea. Case Rep Obstet Gynecol 2018; 2018:5065738. [PMID: 29607236 PMCID: PMC5828537 DOI: 10.1155/2018/5065738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/26/2017] [Indexed: 11/19/2022] Open
Abstract
Primary non-Hodgkin's lymphoma (NHL) can arise from lymphatic cells located in solid organs (extranodal) and it accounts for 25 to 35% of all NHL. Primary lymphoma on the female genital tract (PLFGT) is a rare disease, comprising 0.2 to 1.1% of all extranodal lymphomas in the female population. In this paper, the authors report an extremely rare case of a 48-year-old woman who exhibited an abnormal uterine bleeding, pelvic pain, and dysmenorrhea history. The transvaginal ultrasound showed an anteverted uterus measuring 153 cm3 in volume, with intramural leiomyomas. She underwent a total laparoscopic hysterectomy with bilateral salpingectomy. The histologic evaluation of the specimen showed a follicular lymphoma with diffuse pattern in the endometrium. This report illustrates the difficulty in the diagnosis of primary lymphomas of the female genital tract.
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Martin A, Medlin E. Primary, non-germinal center, double-expressor diffuse large B cell lymphoma confined to a uterine leiomyoma: A case report. Gynecol Oncol Rep 2017; 22:78-81. [PMID: 29159259 PMCID: PMC5678734 DOI: 10.1016/j.gore.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/14/2017] [Accepted: 10/16/2017] [Indexed: 12/02/2022] Open
Abstract
Primary lymphoma of the female genital tract accounts for 1% of extranodal lymphomas. Approximately 13% are diffuse large B cell lymphoma of the uterus, most often involving the endometrial stroma or cervix. The first double-expressor diffuse large B cell lymphoma confined to a uterine leiomyoma is described.
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Affiliation(s)
- Alexandra Martin
- Corresponding author at: 529 South Jackson Street, Louisville, Kentucky 40202, United States.529 South Jackson StreetLouisvilleKentucky40202United States
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