Background/Introduction: Female genital tract lymphoma is an extremely rare diagnosis¹ accounting for only 1.5% of extra nodal non-Hodgkin’s lymphoma and a meagre less than 0.5% of gynaecological cancer². Primary lymphoma of cervix is considered less common compared to cervical involvement in a multi organ disease³. Majority of these rare cases are diagnosed during routine screening on Papanicolaou (Pap) cytology smear⁴.

Due to the limited number of primary lymphoma of the cervix, a standard regime has not been developed^5.

This is a case report of a 73 year old non-English speaking background lady who presented to her obstetrician with one month history of post-menopausal bleeding per vaginum. Histology revealed a high grade large B cell non-Hodgkin’s lymphoma with a high proliferative index, expressing C-MYC protein in a high proportion of cells and CD10 and LCA positive on a cervical biopsy.

Objectives: This poster presents the rarity of cervical lymphoma; including its incidence, clinical presentation and diagnostic dilemma from benign conditions as well as treatment regime.

Methods (including type of data collected): Case report and literature search/review on Pubmed/MEDLINE. Comparing both in terms of presentation, diagnosis and treatment management. 

Results: Patient has been diagnosed in a timely manner and appropriately managed as well as treated. 

Conclusions: This presentation of cervical diffuse large B cell non-Hodgkin’s lymphoma highlights the importance of having an absolute open mind when working up patients presenting with common symptoms in gynaecology like bleeding per vaginum and understanding the different management approaches for these rare conditions.

References:

1. I. Carr, A. S. Hill, B. Hancock, and F. E. Neal, “Malignant lymphoma of the cervix uteri: histology and ultrastructure,” Journal of Clinical Pathology, vol. 29, no. 8, pp. 680–686, 1976
2. M. S. Basta and A. A. R. Andrawes, “Female genital tract lymphoma: a review of diagnosis and management,” Social Science Research Network. 2009
3. M. S. Thyagarajan, M. J. Dobson, and A. Biswas, “Appearance of uterine cervical lymphoma on MRI: a case report and review of the literature,” British Journal of Radiology, vol. 77, no. 918, pp. 512–515, 2004
4. W. Y. Au, B. C. P. Chan, L. P. Chung, and C. Choy, “Primary B-cell lymphoma and lymphoma-like lesions of the uterine cervix,” American Journal of Hematology, vol. 73, no. 3, pp. 176–179, 2003
5. E. L. Stroh, P. C. Besa, J. D. Cox, L. M. Fuller, and F. F. Cabanillas, “Treatment of patients with lymphomas of the uterus or cervix with combination chemotherapy and radiation therapy,” Cancer, vol. 75, no. 9, pp. 2392–2399, 1995