Key words cervical tumor; lymphoma; lymphoma-like lesions
1 Clinical data
Patients, female, 60 years old, postmenopausal vaginal bleeding 15 days to come to our hospital on March 13, 2006. Vaginal bleeding, patients with no obvious incentive to medium, no abdominal pain, bloating, fever, fatigue and other discomfort, a history of diabetes, history of hypertension. Examination: vital signs were stable, general superficial lymph nodes were not palpable enlargement, heart and lung (-), liver and spleen not palpable; gynecological examination: mild cervical erosion, touch of easy bleeding, hard, no other special. The body the examination not found in other parts of the lesions.
Pathological examination: cervical tissue mucosa a large transformation lymphoproliferative mother cells and follicular center cell follicular center, surrounded by mixed large number of plasma cells and other inflammatory cells, cervical glands are squeezed separated part of the gland is violated. Immunohistochemistry: κ (+), λ (-), CD3 (-), CD45RO (-), CD20 (+), CD79α (+), AE1/AE3 (-) the CgA (-). Pathological diagnosis: primary cervical non-Hodgkin’s lymphoma (B-cell).
Primary cervical lymphoma is very rare, accounting for about 1% of all non-Hodgkin’s lymphoma , accounting for 0.9% of the same period in primary cervical cancer , the vast majority of B-cell lymphoma, the prognosis relatively good. General systemic symptoms such as fever, anemia, lymphadenopathy. Most cervical erosion or cervical diffuse enlargement, or was polypoid changed, rare ulcer formation. Histology showed diffuse large cell lymphoma morphology visible dysplasia lymphocytes infringement cervical glands, consider a detailed examination should be carried out lymphoma, to the exclusion of other parts of lymphoma involving the cervical, and immunohistochemical staining should be done differential diagnosis, κ, λ B cell markers (CD20, CD79α), T cell markers (CD3, CD5, CD45RO), AE1/AE3, CgA conditions feasible TCR and IgH gene rearrangement. The cases of pelvic radiotherapy field follow-up of 16 months, patients still generally good.
Cervical lymphoma is rare, easily misdiagnosed or missed diagnosis should be lymphoma-like lesions and cervical, small cell undifferentiated carcinomas. (1) cervical lymphoma-like lesions, also known as “pseudo lymphoma, is a rare benign lymphoproliferative lesions, clinical manifestations of cervical lymphoma is very similar to the morphological manifestations of reactive lymphoid tissue hyperplasia seen The large number of immature lymphocytes, cell atypia obvious, but the former is immune phenotype showed lymphoid tissue was polyclonal hyperplasia, namely κ, λ are positive TCR and IgH gene rearrangement showed no monoclonal bands . (2) undifferentiated small cell carcinoma, nested patchy distribution of tumor cells by immunohistochemical staining lymphoma is not difficult to identify, the former AE1/AE3, EMA positive.