Non-Hodgkin's Lymphomas Involving the Uterus: A Clinicopathologic Analysis of 26 Cases

Abstract

Non-Hodgkin's lymphomas (NHL) involving the uterus may be either low-stage neoplasms that probably arise in the uterus (primary) or systemic neoplasms with secondary involvement. In this study, 26 NHL involving the uterus are reported. Ten cases were stage I E or II E and are presumed to be primary. The mean age of patients at presentation was 55 years (range, 35 to 67 years), and abnormal uterine bleeding was the most frequent complaint (six patients). Nine of 10 tumors involved the cervix. Histologically, eight were diffuse large B-cell lymphoma (DLBCL); one was follicle center lymphoma, follicular, grade 1; and one was marginal zone B-cell lymphoma. At 5 years of clinical followup, five of six patients were alive after treatment. In 12 cases, uterine involvement was part of a systemic disease at diagnosis, either stage III E or IV. The mean patient age at the time that uterine involvement was detected was 58 years (range, 22 to 75 years); 6 of 12 had abnormal uterine bleeding. Six tumors involved both cervix and corpus, four corpus, and two cervix. Six were DLBCL; two were small lymphocytic lymphoma; three were follicle center lymphoma, follicular, grade 1 (two cases) or grade 2 (one case); and one was precursor T-cell lymphoblastic lymphoma. At 5 years of clinical follow-up, two of seven patients were alive after treatment. Four DLBCL arose in patients with incomplete clinical information; therefore, stage is unknown. We conclude that low-stage (presumably primary) uterine NHL are most commonly DLBCL, predominantly arise in the cervix, and cause abnormal uterine bleeding. High-stage NHL are a heterogeneous group of B-cell neoplasms that can involve the cervix or the corpus.

A case of primary MALT lymphoma of the endometrium presenting as an asymptomatic polyp

“…Only a few cases of MALT lymphoma have so far been recorded in the uterus [1][2][3][4][5][6] (Table 1), and none of these occurred in the form of an endometrial polyp, as seen in our patient. Of these cases, three presented with extensive lymphomatous infiltration of the uterine corpus that produced either uniform enlargement of the organ [1,3] or a mass [4].…”

“…Of these cases, three presented with extensive lymphomatous infiltration of the uterine corpus that produced either uniform enlargement of the organ [1,3] or a mass [4]. The remaining three occurred in the cervix with the clinical features of cervical dysplasia [2], endocervical polyp without ulceration of the mucosal surface [5], and cervical leiomyoma [6], respectively. Notably, only one of these was staged IA likewise the case herein described [2].…”

“…The remaining three occurred in the cervix with the clinical features of cervical dysplasia [2], endocervical polyp without ulceration of the mucosal surface [5], and cervical leiomyoma [6], respectively. Notably, only one of these was staged IA likewise the case herein described [2].…”

Primary extranodal CD8 positive epitheliotropic T-cell lymphoma arising in a leiomyoma of the uterus

“…Fewer than 0.1% of primary uterine neoplasms are malignant lymphomas, and only 0.5% of primary extranodal non-Hodgkin's lymphoma originate in the uterus 2 . Most lymphomas were either low-or high-grade B-cell lymphomas 2,7,8 . There are only a few reports of extranodal non-Hodgkin's lymphoma of T-cell type arising in the uterus 7,9 -11 .…”

Primary follicular lymphoma of the cervix uteri: a review

“…Until now, more than 130 cases of primary NHL of the cervix have been reported. The most common histological subtype is diffuse large B-cell lymphoma [3]. Only 11 cases with low-grade follicular lymphoma of the cervix were reported comprising 8.5% of the primary cervix lymphomas [2][3][4][5][6][7][8][9].…”