Primary diffuse large B cell lymphoma of the uterine cervix successfully treated by combined chemotherapy alone

Cubo, Ana María; Soto, Zandra Mileny; Crúz, Miguel A.; Doyague, M.; Sancho, Verónica; Fraino, Aurymar; Blanco, Óscar; Puig, Noemí; Alcoceba, Miguel; González, Marcos; Sayagués, José María

doi:10.1097/md.0000000000006846

Cited by 38 publications

(32 citation statements)

References 20 publications

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“…In case 2, primary lymphoma of the cervix, which is an exceedingly rare neoplasm ( 41 ) and typically consist of diffuse large B-cell lymphoma (DLBCL) ( 42 ) was excluded for morphological analysis and immunophenotyping. In fact, tumor cells in DLBCL generally express pan B-cell antigens (CD19, CD20, CD22 and CD79a) and are negative for neuroendocrine markers ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine small cell carcinoma of the cervix: A case report

et al. 2021

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Merkel cell polyomavirus (MCPyV) has been found in patients with Merkel cell carcinoma and respiratory tract infections. Merkel cell carcinoma is a primary aggressive neuroendocrine carcinoma of the skin. It has been demonstrated that MCPyV can be transmitted during sexual activity and may be present in the oral and anogenital mucosa. The aim of the present study was to evaluate whether MCPyV coexisted with HPV in three cases of neuroendocrine small cell carcinoma of the cervix using PCR and immunohistochemical analysis Three cases of NSC of the cervix were identified in the pathology archives of Parma University (Italy). Of these, two cases were associated with an adenocarcinomatous component. A set of general primers from the L1 region (forward, L1C1 and reverse, L1C2 or L1C2M) was PCR amplified to detect the broad-spectrum DNA of genital HPV. The presence of MCPyV was investigated via immunohistochemistry using a mouse monoclonal antibody against the MCPyV LT antigen and through PCR analysis to separate viral DNA. HPV DNA was present in all three neuroendocrine carcinomas and in the adenocarcinoma component of the two mixed cases. None of the cases were immunoreactive to CM2B4 and did not contain viral DNA in either their neuroendocrine or adenocarcinomatous component. Whilst it is difficult to draw definitive conclusions from such a small sample size, these data suggested that MCPyV does not coexist with HPV in the cervix. However, in the present study, the absence of detectable MCPyV may have been due to the presence of a genotype that was not detected by the primers used in the PCR analysis or by the antibody used for the immunohistochemical study. MCPyV microRNA may also have been present, inhibiting LT expression. Additional studies with larger cohorts and more advanced molecular biology techniques are required to confirm the hypothesis of the current study.

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Section: Discussionmentioning

confidence: 99%

Neuroendocrine small cell carcinoma of the cervix: A case report

et al. 2021

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“…[ 4 ] Its global incidence is about 3%, and the incidence of extranodal lymphoma accounts for 15% of NHL, whose clinical manifestations are diverse. [ 5 ] Primary lymphoma of the female genital tract (PLFGT) is a very rare entity, comprising 0.2–1.1% of all cases of extra-nodal lymphoma. PLFGT most commonly can arise from the ovary, uterus, cervix, vagina and vulva.…”

Section: Discussionmentioning

confidence: 99%

Primary diffuse large B-cell lymphoma of the fallopian tube treated with a combination of surgery and chemotherapy

et al. 2021

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Rationale: Primary female genital tract lymphomas are sporadic neoplasms, accounting for 0.2% to 1.1% of all cases of extranodal lymphoma. The most common genital localizations are the cervix, the uterine corpus and the ovary, while primary lymphomas of the fallopian tube are quite unusual. According to literature searching in PubMed, this is the first reported case of primary diffuse large B-cell lymphoma of the fallopian tube. Patient concerns: A 52-year-old woman presented with a more than 2 months history of intermittent lower abdominal pain. The gynecological examination showed that the uterus, as big as 3 months of pregnancy, had weak activity and no tenderness. The uterine rectum lacuna was like a hard nodule of about 3 × 2 cm, and an irregular solid mass was fixed and inactive in the right adnexa. Diagnoses: In accordance with Ann Arbor staging system, a stage IE primary diffuse large B-cell lymphoma of fallopian tube was diagnosed for this patient, based on the tumor pathology, the results of bone marrow biopsy and computed tomography (CT) scan. Interventions: After gynecological/urinary ultrasound, blood test, pelvic contrast enhanced CT scan and CT angiography of iliac artery, exploratory laparoscopy and following hysterectomy with bilateral salpingo-oophorectomy were performed. After the surgery, the patient was treated with combined Rituximab and chemotherapy and got complete response (CR). Outcomes: After the operation and R-CHPOP, following up for more than 1 year so far, the patient has no tumor recurrence and is still in good condition. Lessons: It is very difficult to diagnose the primary diffuse large B-cell lymphoma of fallopian tube, not only because of its rarity, but also because of its non-specific clinical manifestations. It easily be treated as late ovarian cancer by gynecologist. So the pathology diagnosis and surgeons’ decision is very important. Because lymphoma is pretty sensitive to chemotherapy and easy to get complete response, so we no need to do an operation like ovarian cancer and should put chemotherapy as a primary method for lymphomas of the female genital tract.

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“…5,13 Cubo et al 15 noted that with the passage of time chemotherapy with or without radiation therapy has become the preferred treatment option in contrast to previous treatment plans in which surgery was the predominant modality. 15 Furthermore, the addition of the monoclonal antibody rituximab to chemotherapeutic agents (cyclophosphamide, doxorubicin, oncovin and prednisolone (R-CHOP) has resulted in an increased overall survival for patients with DLBCL. 15 Fertility preservation may be a consideration in younger patients and as such radiation therapy may be omitted to prevent premature ovarian failure.…”

Section: Discussionmentioning

confidence: 99%

“…15 Furthermore, the addition of the monoclonal antibody rituximab to chemotherapeutic agents (cyclophosphamide, doxorubicin, oncovin and prednisolone (R-CHOP) has resulted in an increased overall survival for patients with DLBCL. 15 Fertility preservation may be a consideration in younger patients and as such radiation therapy may be omitted to prevent premature ovarian failure. Alternatively, ovarian translocation may be carried out to shield the ovaries from the radiation field.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma of the endometrium: an unusual site for primary presentation

Wadee

2019

Southern African Journal of Gynaecological Oncology

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Diffuse large B-cell lymphomas are fairly common adult haematolymphoid malignancies. Approximately 40% of such tumours may present in an extranodal site. These lymphomas are, however, infrequently identified in the female genital tract and even more rarely, identified in the endometrium. The histopathological features and molecular findings of endometrial diffuse large B-cell lymphoma are discussed herein. A 36-year old female presented with per vaginal bleeding. She underwent an endometrial curettage, which demonstrated morphological and immunophenotypical features of a diffuse large B-cell lymphoma. Amplification of the immunoglobulin heavy chain (IgH) gene by polymerase chain reaction (PCR) confirmed B-cell clonality. Epstein-Barr encoding region (EBER) in-situ hybridisation was positive in tumour cells. Fluorescent in-situ hybridisation (FISH) for the detection of BCL6 and MYC gene rearrangement as well as for the detection of the t(14;18) (q32;q21) translocation was performed, all of which yielded negative results. Unfortunately, the patient was lost to follow-up. Whilst diffuse large B-cell lymphoma is not a commonly identified tumour within the uterine cavity, it should be included in the differential diagnosis of endometrial neoplastic infiltrates so as not to misdiagnose this tumour. This facilitates rapid commencement of further management for the patient.

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Primary diffuse large B cell lymphoma of the uterine cervix successfully treated by combined chemotherapy alone

Cited by 38 publications

References 20 publications

Neuroendocrine small cell carcinoma of the cervix: A case report

Neuroendocrine small cell carcinoma of the cervix: A case report

Primary diffuse large B-cell lymphoma of the fallopian tube treated with a combination of surgery and chemotherapy

Diffuse large B-cell lymphoma of the endometrium: an unusual site for primary presentation

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