Article Text
PDF
Abstract
Introduction/Background Primary non-Hodgkin large B-cell lymphoma of the cervix and the uterus are extremely rare types of cancer. The symptoms can often mimic endometrial or cervical cancer and the diagnosis and treatment can as a result of this be delayed. Treatment options vary and include a combination of surgery, chemotherapy and radiotherapy according to current lymphoma management guidelines. We present two cases of diffuse large B-cell lymphoma originating in the uterus and the cervix. We have also reviewed the available evidence for management and to highlight the difficulty in making the diagnosis and deciding on treatment of these rare cases.
Methodology Case 1: A 76-year-old woman presented with pelvic pain and abdominal pressure symptoms. CT revealed a large suspicious uterine mass measuring 15cm. The patient underwent a laparotomy and total abdominal hysterectomy with bilateral salpingo-oophorectomy, omental biopsy and removal of enlarged pelvic lymph nodes. Histology confirmed a diffuse large B-cell lymphoma NOS. Three months from the operation is continuing on R-CHOP without signs of recurrence.
Results Case 2: A 52-year-old woman presented with post-menopausal bleeding and a bulky cervix and bilateral pelvic sidewall lymph nodes confirmed on MRI scan. Cervical biopsies 1, 3 and 24 months (including LLETZ) and lymphadenectomy 3 months after the first presentation following review by specialist lymphoma pathologists, showed chronic inflammation only. Large loop biopsy of the cervix 34 months after the first presentation revealed a diffuse large B cell lymphoma (GC type) which was treated with R-CHOP chemotherapy. 63 months later, the patient is alive with no signs of recurrence.
Conclusion Primary Large B-Cell lymphoma of the female reproductive system, due to the rarity of the diagnosis and symptomatology that resembles more common conditions, it is a diagnostic challenge even for experts in the field. These two cases highlight the difficulty in diagnosis and the variation of treatment options that these cases might benefit from.
Disclosures The authors declare that they have no relevant or material financial interests that relate to the research described in this paper.
