Primary non-Hodgkin's lymphoma of the vagina: A case report

Abstract

Primary non-Hodgkin's lymphoma (NHL) of the vagina is uncommon. The present case study reports the case of a 54-year-old female with a palpable mass between the rectum and vagina. The patient presented with symptoms consistent with vaginal cancer but lacked any of the ‘B’ symptoms often associated with systemic lymphoma, including fever, weight loss, night sweats and fatigue. The mass was resected under anesthesia. Immunohistochemistry and biopsy confirmed diffuse large B-cell NHL (DLBCL). Following surgery, six cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone were administered. Subsequently, a vertebral body metastasis was observed using a computed tomography scan and whole-body bone imaging. The patient received palliative radiation for the vertebral body metastasis. Additionally, the available literature was reviewed in order to further characterize this rare disease.

Primary non-Hodgkin’s lymphoma of the vagina (PNHLV): a gynaecologist’s enigma!

“…It is important to obtain sufficient tissue material to perform not only conventional histopathological examination, but also for immunohistochemistry, cytogenetics (fluorescent in situ hybridisation) and molecular genetics in order to establish the correct histological subtype of lymphoma. Immunohistochemistry also helps in ruling out other differentials of firm, smooth non-ulcerated vaginal lesions such as Ewing’s sarcoma, mixed Mullerian tumour, melanoma and neuroendocrine tumours 6. In our case due to a sufficient biopsy taken, diagnosis was made at first biopsy however as illustrated by a case report diagnosis can be delayed with insufficient biopsy and hence the importance of adequate biopsy 4…”

“…Unlike nodal NHL, which usually manifests with prodromal symptoms of fever, night sweats, weight loss or ‘B’ symptoms, genital lymphomas rarely present with these symptoms 6. Of the known cases thus far, the most common clinical presentations were vaginal bleeding (34.8%), vaginal mass (23.9%), vaginal discharge (17.4%) and abdominal/pelvic pain (15.2%).…”

Diffuse large B-cell lymphoma of the vagina in pregnancy

“…Squamous cell carcinoma is the most common histological type, while primary lymphoma of the vagina is rare 7. DLBCL is the most common vaginal lymphoma while Burkitt’s lymphoma was even more rare 3 8–11. The reported age at presentation varies widely between 15 and 79 years.…”

FDG PET/CT Showing a Primary Vaginal NK/T Cell Lymphoma

“…[3][4][5][6] Primary lymphoma of vagina is very rare, and the most common histological type is diffuse large B-cell lymphoma. 7 Vaginal primary cancer, 8 metastasis, 9 melanoma, 10 leiomyosarcoma, 11 and bacterial vaginosis 12 can show intense FDG uptake. This case expanded our knowledge about ENKTL and the list of differential diagnosis when we interpret vaginal FDG-avid lesions on PET/CT.…”