Lagoo Anand S, Robboy Stanley J
Department of Pathology, Duke University Medical Center, Durham, NC 27110, USA.
Int J Gynecol Pathol. 2006 Jan;25(1):1-21. doi: 10.1097/01.pgp.0000183049.30212.f9.
: Primary lymphomas affecting the female reproductive system are uncommon but often pose a diagnostic challenge if their existence is not suspected. This article reviews the pathological and clinical features of lymphomas occurring in various sites in the female genital tract including the vulva, vagina, cervix, endometrium, fallopian tubes, and ovaries. Using the recent World Health Organization classification, the various types of lymphomas are identified as separate diseases and not as morphological variations of the same disease. The immunophenotypic and cytogenetics features of the major lymphomas are summarized. The incidence, presenting symptoms, gross and microscopic features, major differential diagnostic considerations, response to therapy, and expected outcome are discussed. Using published data on patient outcome, the International Federation of Obstetricians and Gynecologists and Ann Arbor staging systems are compared for their predictive value, and the difficulty in assigning primary and secondary status in extranodal lymphomas is emphasized. The observed differences in the behavior of some lymphomas in gynecological sites compared with their usual nodal location are presented. Finally, the possible etiology of these conditions is discussed in light of the emerging paradigm of mucosa-associated lymphoid tissue lymphomas.
原发性淋巴瘤累及女性生殖系统并不常见，但如果未怀疑其存在，往往会带来诊断挑战。本文回顾了发生于女性生殖道各个部位（包括外阴、阴道、宫颈、子宫内膜、输卵管和卵巢）的淋巴瘤的病理和临床特征。根据世界卫生组织最近的分类，将各种类型的淋巴瘤确定为不同的疾病，而非同一疾病的形态学变异。总结了主要淋巴瘤的免疫表型和细胞遗传学特征。讨论了发病率、临床表现、大体和显微镜下特征、主要鉴别诊断要点、治疗反应及预期转归。利用已发表的患者转归数据，比较了国际妇产科联合会和Ann Arbor分期系统的预测价值，并强调了在结外淋巴瘤中确定原发和继发状态的困难。介绍了一些淋巴瘤在妇科部位的行为与其通常在淋巴结部位的行为之间观察到的差异。最后，根据黏膜相关淋巴组织淋巴瘤的新兴模式讨论了这些疾病可能的病因。
