Okudaira Taeko, Nagasaki Akitoshi, Miyagi Takashi, Nakazato Tetsuro, Taira Naoya, Kudaka Wataru, Maehama Toshiyuki, Takasu Nobuyuki
Dept. of Endocrinology and Metabolism, Internal Medicine, University of The Ryukyus School of Medicine.
Gan To Kagaku Ryoho. 2008 Aug;35(8):1423-5.
Primary malignant lymphoma of the female genital tract is an extremely rare clinical entity. We report a case of primary non-Hodgkin lymphoma of the uterine cervix. A 68-year-old woman presented with abnormal genital bleeding in May 2002. A coloposcopic examination revealed a mass in the uterine cervix. Magnetic resonance imaging showed a bulky cervical tumor(7.5 x 8 cm)invading the right parametrium and adjacent levator ani muscle. Involvement of pelvic lymph nodes was also observed. The uterine lesion exhibited homogenous hypointensity on T1 weight image and isointense to hyperintense on T2-weight image. No other lesions were detected by the whole-body computed tomography, gallium scintigraphy, and bone marrow examination. Although cytology of the smear from the uterine cervix was nondiagnostic, the histologic examination of the punch biopsy material showed a diffuse proliferation of atypical lymphoid cells. Immunophenotypic studies revealed tumor cells were positive for CD19, CD20, CD30, and k-chain. A diagnosis of diffuse large B-cell lymphoma of the uterine cervix, clinical stage IIE was made. The patient was treated with 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone(CHOP)chemotherapy followed by the involved field irradiation. She remains alive and free of disease more than 5 years after the diagnosis.
女性生殖道原发性恶性淋巴瘤是一种极为罕见的临床病症。我们报告一例子宫颈原发性非霍奇金淋巴瘤病例。一名68岁女性于2002年5月出现生殖器异常出血。阴道镜检查发现子宫颈有一肿物。磁共振成像显示一个巨大的宫颈肿瘤(7.5×8厘米),侵犯右侧子宫旁组织及相邻的肛提肌。还观察到盆腔淋巴结受累。子宫病变在T1加权图像上呈均匀低信号,在T2加权图像上呈等信号至高信号。全身计算机断层扫描、镓闪烁显像和骨髓检查未发现其他病变。尽管子宫颈涂片细胞学检查未明确诊断,但穿刺活检材料的组织学检查显示非典型淋巴细胞弥漫性增生。免疫表型研究显示肿瘤细胞CD19、CD20、CD30和κ链呈阳性。诊断为子宫颈弥漫性大B细胞淋巴瘤,临床分期为IIE期。该患者接受了6个周期的环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)化疗,随后进行受累野照射。诊断后5年多,她仍然存活且无疾病复发。