El Miski F, Hanafi A, Telmoudi E, Bousada Z, Abbassi I El, Jalal M, Lamrissi A, Fichtali K, Bouhya S
Obstetrics and Gynecology Department, Univesity Hospital Center Ibn Rochd, Casablanca, 20100, Morocco.
Ann Med Surg (Lond). 2021 Jul 27;68:102607. doi: 10.1016/j.amsu.2021.102607. eCollection 2021 Aug.
Primary non-Hodgkin's malignant lymphoma (NHML) of the uterine body is an extremely rare localization since only eleven cases have been reported in the literature.
We report a case of primary NHML of the uterine body discovered during a hysterectomy performed for a uterine mass. The primary character of NHML of the uterine body was retained in view of the absence of extra-genital localization in the clinical, biological and radiological workup (Ann Arbor stage IE) and there were no signs of recurrence during follow-up. The patient received anti-CD20 immunochemotherapy (rituximab-CHOP and rituximab-VCAP combinations) and at 12 months follow-up, she is in complete remission.
The diagnosis of primary and isolated NHML of the uterine body is based on a clinical and further examination and regular follow-up for several months. The treatment is not codified; surgery, poly-chemotherapy and radiotherapy are the different therapeutic modalities. Rituximab-CHOP immunochemotherapy is currently the reference treatment for primary malignant lymphomas of the uterine body particularly in young patients who wish to become pregnant. The prognosis depends mainly on two factors: age and Ann Arbor stage.
Primary uterine lymphomas are rare tumors of unknown etiopathogeny and of non-specific clinical presentation, the role of the various treatments remains difficult to evaluate due to the small number of published cases.
子宫体原发性非霍奇金恶性淋巴瘤（NHML）是一种极为罕见的发病部位，因为文献中仅报道过11例。
我们报告一例在因子宫肿物行子宫切除术中发现的子宫体原发性NHML。鉴于在临床、生物学和影像学检查中未发现生殖器外病变（Ann Arbor分期IE期），子宫体NHML的原发性特征得以保留，且随访期间无复发迹象。患者接受了抗CD20免疫化疗（利妥昔单抗-CHOP和利妥昔单抗-VCAP联合方案），在12个月的随访中，她处于完全缓解状态。
子宫体原发性孤立性NHML的诊断基于临床及进一步检查，并进行数月的定期随访。治疗方案尚无定论；手术、多药化疗和放疗是不同的治疗方式。利妥昔单抗-CHOP免疫化疗目前是子宫体原发性恶性淋巴瘤的参考治疗方案，尤其适用于希望怀孕的年轻患者。预后主要取决于两个因素：年龄和Ann Arbor分期。
原发性子宫淋巴瘤是病因不明且临床表现无特异性的罕见肿瘤，由于已发表病例数量较少，各种治疗方法的作用仍难以评估。
