Romero-Guadarrama MB, Durán-Padilla MA

Language: Spanish
References: 17
Page: 109-114
PDF size: 399.64 Kb.

ABSTRACT

Primary lymphomas originate in the female tract, such as the vagina, cervix, and uterine body are uncommon (less than 3%). The objective of this paper is to comment the clinicopathological characteristics of a primary lymphoma of the uterine cervix and its differential diagnosis. A 27 years old woman, had history of transvaginal bleeding and weight loss of 7 kg, without symptoms for 9 months of evolution. At the physical exploration revealed an infiltrating tumor of the uterine cervix, which prompted a biopsy. The tumor was composed of large pleomorphic cells, with abundant cytoplasm and irregular nuclei with frequent mitoses and sclerosis. Pan B-cell marker (CD 20) was positive in the cytoplasmic membrane of the neoplastic cells, leading to the diagnosis of diffuse large B-cell lymphoma. Positron emission tomography (PET) revealed the tumor in the uterine cervix without lymphadenopathy; six cycles of chemotherapy (CHOP protocol) were administered. Primary lymphomas of the female genital tract are uncommon and affect women between 20 and 80 year of age. The most common symptom is transvaginal bleeding, they infiltrate diffusely, in «barrel» shape. They rarely present polypoid nodes. Histologically they are composed of large pleomorphic cells, and frequently depict sclerosis. Differential diagnosis must be made with regard to reactive lymphoid infiltrates, myeloid sarcoma, plasmacytoma, malignant melanoma, and undifferentiated carcinoma. The cytological characteristic of the cells can orient the diagnosis; however, it is important to determine immunohistochemical markers.

REFERENCES

1. Chorlton I, Karnei RF, King FM et al. Primary malignant reticuloendothelial disease involving the vagina, cervix and corpus uteri. Obstet Gynecol 1974; 44: 735-748.

2. Popoff NA, Malinin TI. Cytoplasmic tubular arrays in cells of American Burkitt´s lymphoma. Cancer 1976; 37: 275.

3. Berard, CW. O´Connor, GT, Thomas LB, Torloni H. Histopathology definition of Burkitt’s tumor. Bull WHO 1969; 40; 601-607.

4. Muntz HG, Ferry JA, Flynn D et al. Stage IE? Primary malignant lymphomas of the uterine cervix. Cancer 1991; 68: 2023-2032.

5. Vang R, Medeiros LJ, Fuller GN, Sarris AH, Deavers M. Non-Hodgkin’s lymphoma involving the gynecologic tract: A review of 88 cases. Adv Anat Pathol 2001; 8: 200-217.

6. Feller AC, Diebold J. Histopathology of Nodal and Extranodal Non-Hodgkin’s Lymphomas. Based on the WHO Classification. Springer-Verlag Berlin Heidelberg 2004; 278-279.

7. Latteri MA, Cipolla C, Gebbia V, Lampasona G, Amato C, Gebbia N. Primary extranodal non-Hodgkin lymphomas of the uterus and the breast: Report of three cases. Eur J Surg Oncol 1995; 21: 432-434.

8. Renno SJ, Moreland WS, Pettenati MJ, Beaty MW, Keung YK. Primary malignant lymphoma of uterine corpus: case report and review of Literature. Ann Hematol 2002; 81: 44-47.

9. Aozasa K, Saeki K, Ohsawa M, Horiuchi KM Mishima K, Tsujimoto M. Malignant lymphoma of the uterus. Report of seven cases with immunohistochemical study. Cancer 1993; 72: 1959-1964.

10. Young RH, Harris NL, Scully RE. Lymphoma-like lesion of the lower female genital tract. A report of 16 cases. Int J Gynecol Pathol 1985; 4: 289-293.

11. Geyer JT, Ferry JA, HarrisNL, Youung RH, Longtine JA, Zukerber LR. Florid reactive lymphoid hyperplasia of the lower female genital tract (lymphoma-like Lesion): A benign condition that frequently harbors clonal immunoglobulin heavy chain gene rearrangements. Am J Surg Pathol 2010 (Epub ahead of print).

12. Hernández RJA, Navarro FJ, Ribera SJM, Del Río BN et al. Sarcoma mieloide: Características clinicopatológicas y tratamiento. http: //www.siicsalud.com/dato/dat040/04921001.htm

13. Oliva E, Ferry JA, Young RH et al. Granulocytic sarcoma of the female genital tract: Clinicopathologic study of 11 cases. Am J Surg Pathol 1997; 21: 1156-1160.

14. Paydas Semra, Suzan Zorfidemir and Ergin Melek. Granulocytic sarcoma: 32 cases and review of the literature. Leukemia and Lymphoma 2006; 47: 2527-2541.

15. Doss LL. Simultaneous extramedullary plasmacytomas of the vagina and vulva: A case report and review of the literature. Cancer 1978; 41: 2468-2470.

16. Hall DJ, Schneider V, Goplerud DR. Primary malignant melanoma of the uterine cervix. Obstet Gynecol 1980; 56: 525-527.

17. Zaino RJ, Ward S, Delgado G et al. Histopathologic predictors of the behavior of surgically treated stage IB squamous cell carcinoma of the cervix : A Gynecologic. Oncology Group Study. Cancer 1992; 69: 1750-1754.