Malignant lymphoma of the uterine cervix presumptively diagnosed by Pap smear: A case report

Abstract

Malignant lymphoma of the uterine cervix is exceedingly rare and is difficult to diagnose by cervical cytology. The current study presents a case of malignant lymphoma of the uterine cervix that was presumptively diagnosed by cervical cancer screening in which the patient had no clinical symptoms. The anterior lip of the uterine cervix was occupied by a macroscopic hemorrhagic tumor. The obtained tumor cells exhibited typical cytological features of malignant lymphoma and were positive for CD20. The final diagnosis was diffuse large B cell lymphoma of the uterine cervix, stage IIEA (Ann Arbor classification). The patient received 6 courses of R-CHOP chemotherapy and achieved complete remission. Despite its rarity, the possibility of malignant lymphoma should be considered while screening for cervical cancers using Pap smears. The Pap test screening may be useful for the early diagnosis of malignant lymphoma of the uterine cervix in certain cases. By reaching a rapid and accurate diagnosis, immediate treatment may be initiated and surgery may be avoided.

Primary diffuse large B-Cell lymphoma of the uterine cervix with severe lower urinary tract Symptoms: A rare case report and review of the literature

“…2 cm. – DLBCL (GCB) IE R-CEOP × 6 CR, 12 mo Del et al ( Koyanagi et al, 2018 ) 36 Vaginal bleeding, pelvic pain, dysuria A firm and fixed cervical mass of 7 cm invading the right parametrium and the anterior vaginal wall – DLBCL (GCB) IV R-CHOP × 6 CR, 15 mo Koyanagi et al ( Regalo et al, 2016 2016. ) 74 No clinical symptoms A whitish hemorrhagic tumor occupying the anterior lip of the uterine cervix Non-epithelial malignant tumor, including malignant lymphoma DLBCL IIEA R-CHOP × 6 CR Cubo et al ( Cubo et al, 2017 ) 51 Vaginal bleeding A cervix, with a large exophytic lesio（9 × 10 cm）, infiltrating the upper vagina and both parametria and extending to the pelvic wall – DLBCL (GCB) IE R-CHOP × 6 CR, 24 mo Regalo et al ( Sharma et al, 2016 ) 40 Swelling of the right lower extremity and vaginal bleeding A bulky cervical mass (7.9 × 7.6 cm) – DLBCL IIE R-CHOPx1 + R-CVPx 8; Recurrence: 4 × R-CHOP + pelvic radiotherapy CR, 45 mo（the first therapy）; Asymptomatic, 3 mo(recurrence) Sharma et al ( Sugimoto et al, 2013 ) 61 Vaginal bleeding A 7 × 6 cm mass in the cervix and extending to lower uterus and upper third of vagina – DLBCL IVB R-CHOP × 6 + pelvic radiotherapy × 5 weeks CR Sugimoto et al ( Bull et al, 2013 ) 72 Abdominal fullness A giant, mass that was about the size of a small child’s head ClassⅡto Class III DLBCL – R-THP-COP × 6 CR, 36 mo Bull et al ( Wang et al, 2019 ) …”

Primary diffuse large B-cell lymphoma of uterine cervix diagnosed by cytology and concurrent cervical biopsy: a case report and literatures reviews since 1980

“…In cervical cytology, the detection rate for malignant lymphoma cells has been reported to be 30%-40% [9]. Some researchers described that unlike epithelial tumor, lymphomas arise from the stroma, and that cervical cytology is not sensitive enough to recognize them [3].…”