Institutional Review of Primary Non-Hodgkin Lymphoma of the Female Genital Tract: A 33-Year Experience

Ahmad, Asima; Hui, Pei; Litkouhi, Babak; Azodi, Masoud; Rutherford, Thomas J.; McCarthy, Shirley; Xu, Mina L.; Schwartz, Peter E.; Ratner, Elena

doi:10.1097/igc.0000000000000201

Cited by 41 publications

(48 citation statements)

References 19 publications

(36 reference statements)

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“…Ahmad et al . (24) reported a more favorable prognosis in these patients, while a study from China showed that these patients had a high risk of CNS relapse and therefore had poorer prognosis (25). These issues definitely require comprehensive cooperation to achieve accurate insight into these rare extranodal diseases.…”

Section: Discussionmentioning

confidence: 99%

Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options

Yao

et al. 2017

Chinese Journal of Cancer Research

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ObjectiveExtranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma (DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.MethodsA total of 329 patients were enrolled according to the inclusion requirements. The effects of gender, extranodal involvement, age-adjusted international prognostic index (aaIPI), rituximab infusion and radiotherapy on patient outcomes were evaluated.ResultsAmong these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aaIPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.ConclusionsExtranodal involvement is common in younger patients and exhibits a ubiquitous distribution. The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options

Yao

et al. 2017

Chinese Journal of Cancer Research

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“…This is evident in our case series, as it was seen in 3 of our patients. In general, B-cell lymphomas have a better prognosis and overall response to traditional treatment than T-cell lymphomas (Ahmad et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

“…In our case series, 2 patients out of the 5 reported weight loss and only one experienced malaise. In a recent study of 36 patients with Non-Hodgkin's lymphoma originating in gynecological organs, only 17% patients have such constitutional symptoms (Ahmad et al, 2014). The most common presentation in this large review was vaginal bleeding and enlarging pelvic mass (Ahmad et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study of 36 patients with Non-Hodgkin's lymphoma originating in gynecological organs, only 17% patients have such constitutional symptoms (Ahmad et al, 2014). The most common presentation in this large review was vaginal bleeding and enlarging pelvic mass (Ahmad et al, 2014). Our series resulted in a similar conclusion, with pelvic mass, vaginal bleeding and pelvic pain as the most common findings.…”

Section: Discussionmentioning

confidence: 99%

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Primary gynecological non-Hodgkin's lymphoma: A differential diagnosis of a pelvic mass

Vijayakumar

Serur

Bybordi

et al. 2016

Gynecologic Oncology Reports

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Primary Non-Hodgkin's lymphoma (NHL) can mimic gynecological malignancy, presenting as a pelvic mass in any organ of the female genital tract. Patients can present with elevated CA-125 and may lack the classical symptoms associated with lymphoma, such as fatigue, fever, night sweats and weight loss. We describe five patients that presented with primary NHL of the genital tract. Patients 1, 2, and 3 were not diagnosed pre-operatively, and underwent unnecessary cytoreductive surgery, while patients 4 and 5 were diagnosed by pre-operative biopsy. The diagnosis of primary pelvic lymphoma should be in the differential diagnosis of gynecological malignancies. Awareness of the disease and pre-operative diagnosis can be beneficial, as the patient may be able to avoid unnecessary staging operations and disease cytoreduction.

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“…The clinical diagnosis of primary uterine lymphoma can be challenging, partly because affected patients are often asymptomatic or only have nonspecific symptoms. Of 36 patients diagnosed with non‐Hodgkin's lymphoma of the female genital tract in Yale‐New Haven Hospital, 11% were asymptomatic, 24% presented with vague abdominal complaints, and 14% had constitutional symptoms such as fever, night sweats, and weight loss . Another report concluded that the most common initial presentations are vaginal bleeding or discharge, abdominal or pelvic pain, and rarely urinary obstruction .…”

Section: Discussionmentioning

confidence: 99%

Primary B‐cell lymphoma of the uterine cervix: Presentation in Pap‐test slide and cervical biopsy

Yang

Deisch

Tavares

et al. 2016

Diagnostic Cytopathology

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This case involved a 69-year-old female who presented with irritative urinary voiding. Imaging studies showed an 18-cm uterine mass centering on the cervix and extending into the bladder. The Pap test slide demonstrated necrotic background and degenerative changes in single and grouped atypical "small round blue cells" with high nuclear/cytoplasm ratio, scant cytoplasm, and hyperchromatic focally cleaved nuclei with occasional nuclear membrane "snout projections." Cervical biopsies showed similar findings. The tumor cells were positive for CD45, CD20, and PAX-5, and negative with epithelial, neuroendocrine, and muscle markers. A Ki-67 immunostain showed a markedly elevated proliferative index and the MUM1 stain was diffusely positive. Molecular study identified clonal immunoglobulin heavy chain gene rearrangement. Owing to its rarity, cervical lymphoma may sometimes be confused with other types of malignant neoplasms or inflammatory processes. Therefore, it is important to recognize the cytological features of cervical lymphomas and be aware of the potential diagnostic pitfalls for timely diagnosis and therapy. Diagn. Cytopathol. 2017;45:235-238. © 2016 Wiley Periodicals, Inc.

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Institutional Review of Primary Non-Hodgkin Lymphoma of the Female Genital Tract: A 33-Year Experience

Abstract: Our report is the largest published single-institution experience of this disease. It demonstrates a more favorable prognosis and proposes that with early diagnosis and appropriate therapy, radical gynecologic surgery can be avoided.

Cited by 41 publications

References 19 publications

Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options

Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options

Primary gynecological non-Hodgkin's lymphoma: A differential diagnosis of a pelvic mass

Primary B‐cell lymphoma of the uterine cervix: Presentation in Pap‐test slide and cervical biopsy

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