Primary Vaginal Non-Hodgkin’s Lymphoma: Report of a Rare Clinical Entity

Abstract

A 52-year-old woman was referred to the gynecology outpatient clinic with a 2 months history of vaginal bleeding with intercourse, and no other symptoms. Vaginal examination revealed a firm, non-tender, mass in the posterior vaginal wall. The initial clinical impression was that of a vaginal carcinoma and a biopsy under local anesthesia was performed, but the result was inconclusive. A deeper biopsy, under general anesthesia, was performed and a histological diagnosis of non-Hodgkin’s lymphoma was done. The staging workup permitted to exclude any other site of the body affected by the malignancy. Hematologists reviewed the patient and recommended chemotherapy. A complete tumor regression was observed and the patient has now a disease-free survival of 72 months. This case report intends to create awareness of this rare clinical entity. Although the gynecologist will rarely be faced to extranodal lymphoma, it should be included in the differential diagnosis of gynecologic malignancies.

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

“…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…”

“…It is so rare that out of 9500 women with lymphomas, only six were found to have an initial presentation in the cervix and four in the vagina 2. It is reported in a wide age group (26–66 years), the mean age reported in literature is around 42 years of age 4…”

Primer Vajinal Non-Hodgkin Lenfoma: Olgu Sunumu

“…NHL kemoterapiye çok duyarlı olduğu için cerrahi yöntemler öncelikli bir tedavi seçeneği değildir. Erken evre hastalıkta kemoterapi ve radyoterapinin yer aldığı küratif tedavi modaliteleri uygulanırken, ileri evre hastalıklarda genellikle sadece kemoterapi seçilmektedir (7). Standart kemoterapi rejimi R-CHOP'tur.…”

“…Literatürde sağkalım sonuçlarına baktığımızda primer pelvik bölge lenfomalarında erken tanı ve uygun tedaviler sonrasında 5 yıllık genel sağkalım oranlarının %80-90 olduğu belirtilmiştir (7,(9)(10)(11). Ayrıca, uterin ve vajinal lenfomaların over lenfomalarına göre daha iyi prognoza sahip oldukları bildirilmiştir (9).…”

Lymphoma of vagina in a Nigerian Community

“…The Merriam-Webster's Collegiate Dictionary defines lymphoma as the malignant form of lymphatic tissue and dates 1873 as when it was first named [1]. Now, there are single case reports from Turkey [2], India [3], Italy [4], Portugal [5], China [6], Japan [7], and Spain [8]. Therefore, having encountered the single case, which appeared among the Igbo ethnic group [9], this report is deemed to be worthy of demonstration.…”