Vang R, Medeiros L J, Ha C S, Deavers M
Department of Pathology, The University of Texas-Houston Medical School, USA.
Mod Pathol. 2000 Jan;13(1):19-28. doi: 10.1038/modpathol.3880005.
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 follow-up, 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.
累及子宫的非霍奇金淋巴瘤（NHL）可能是可能起源于子宫的低分期肿瘤（原发性），也可能是继发累及的全身性肿瘤。在本研究中，报告了26例累及子宫的NHL。10例为Ⅰ（E）期或Ⅱ（E）期，推测为原发性。患者就诊时的平均年龄为55岁（范围35至67岁），最常见的主诉是异常子宫出血（6例患者）。10例肿瘤中有9例累及宫颈。组织学上，8例为弥漫性大B细胞淋巴瘤（DLBCL）；1例为滤泡中心淋巴瘤，滤泡性，1级；1例为边缘区B细胞淋巴瘤。经过5年的临床随访，6例患者中有5例治疗后存活。在12例中，子宫受累是诊断时全身性疾病的一部分，为Ⅲ（E）期或Ⅳ期。检测到子宫受累时患者的平均年龄为58岁（范围22至75岁）；12例中有6例有异常子宫出血。6例肿瘤累及宫颈和宫体，4例累及宫体，2例累及宫颈。6例为DLBCL；2例为小淋巴细胞淋巴瘤；3例为滤泡中心淋巴瘤，滤泡性，1级（2例）或2级（1例）；1例为前体T细胞淋巴母细胞淋巴瘤。经过5年的临床随访，7例患者中有2例治疗后存活。4例DLBCL患者的临床信息不完整，因此分期不明。我们得出结论，低分期（推测为原发性）子宫NHL最常见的是DLBCL，主要起源于宫颈，并导致异常子宫出血。高分期NHL是一组异质性B细胞肿瘤，可累及宫颈或宫体。
