Incidentally discovered diffuse large B-cell lymphoma limited to the endocervical mucosa in a young female patient

Gynecol Obstet Invest. 2015;80(2):134-8. doi: 10.1159/000369388. Epub 2015 Apr 14.

Abstract

Primary high-grade non-Hodgkin lymphoma of the female genital tract is extremely rare. Vaginal bleeding, abdominal pain or urinary complaints might be its most frequent symptoms. We report a 27-year-old multipara who underwent large loop excision of the transformation zone because of the repeated finding of a low-grade squamous intraepithelial lesion identified during routine cancer screening. Incidentally, CD20-positive, primary, diffuse large B-cell lymphoma infiltrating the mucosa of the endocervix was also diagnosed from this specimen. The case is unusual because the patient had no symptoms, specific colposcopic signs or visible mass. R-CHOP 21 immunochemotherapy was introduced and resulted in complete remission without hysterectomy. The patient is without any evidence of disease after 49 months of follow-up. Primary cervical lymphomas are mainly subepithelial initially, and therefore they may be under-recognized due to the inefficiency of smears to diagnose such lesions. Early diagnosis and available targeted treatment allowed a cure in the reported example.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antibodies, Monoclonal, Murine-Derived / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / pharmacology
  • Doxorubicin / administration & dosage
  • Doxorubicin / pharmacology
  • Female
  • Humans
  • Incidental Findings
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Mucous Membrane / pathology
  • Prednisone / administration & dosage
  • Prednisone / pharmacology
  • Rituximab
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / drug therapy*
  • Vincristine / administration & dosage
  • Vincristine / pharmacology

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone