Contreras-Chavez Pamela, Aliaga Rolig, Samee Mohammed, Anampa-Guzmán Andrea
Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, USA.
Oncology, Hospital Nacional Arzobispo Loayza, Lima, PER.
Cureus. 2018 Dec 11;10(12):e3713. doi: 10.7759/cureus.3713.
Non-Hodgkin lymphoma (NHL) is a type of blood cancer and 25% of NHL patients present with a primary extranodal tumor. Primary NHL of the vagina is extremely rare with only a few cases reported. We present the case of a 79-year-old, grand multipara, Peruvian woman with an eleven-month history of symptoms of pelvic and vaginal pain and vaginal bleeding. Vaginal examination revealed an exophytic tumor that involved the labia, right vaginal wall, cervix, parametrium, and pelvic bone. A computed tomography (CT) image showed a 10 x 10 x 9-cm solid tumor in the pelvic cavity with irregular edges in the pelvic floor, parametrium, and the perineal soft tissues. Bilateral pelvic and inguinal adenomegalies were found. No signs of metastases were found. Marrow and bone biopsy studies were negative. The diagnosis was NHL type diffuse large B-cell lymphoma (DLBCL) of vagina stage one. The patient was treated with six courses of CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab). She showed a complete response and remained in remission in follow-up control visits. NHL of the female genital tract is rare. CHOP-R is the first line of treatment for this type of cancer. However, less is known about the follow-up protocol and relapse management. Vaginal lymphoma has an extremely low prevalence, and collaborative studies are required to study the same.
非霍奇金淋巴瘤(NHL)是一种血癌,25%的NHL患者以原发性结外肿瘤为首发表现。原发性阴道NHL极为罕见,仅有少数病例报道。我们报告一例79岁、多产的秘鲁女性患者,有11个月的盆腔和阴道疼痛及阴道出血症状史。阴道检查发现一个外生性肿瘤,累及阴唇、右侧阴道壁、宫颈、子宫旁组织和骨盆骨。计算机断层扫描(CT)图像显示盆腔内有一个10×10×9厘米的实性肿瘤,盆底、子宫旁组织和会阴软组织边缘不规则。发现双侧盆腔和腹股沟淋巴结肿大。未发现转移迹象。骨髓和骨活检研究结果为阴性。诊断为阴道弥漫性大B细胞淋巴瘤(DLBCL)1期NHL。该患者接受了六个疗程的CHOP-R(环磷酰胺、阿霉素、长春新碱、泼尼松和利妥昔单抗)治疗。她显示出完全缓解,在随访复查中仍处于缓解状态。女性生殖道NHL较为罕见。CHOP-R是这类癌症的一线治疗方案。然而,对于随访方案和复发管理了解较少。阴道淋巴瘤的患病率极低,需要开展合作研究来进行相关研究。