Kim Sun Yeon, Koo Ju Hwan, Lee Juhun, Koo Yu Jin, Gu Mi Jin, Lee Dae Hyung
Department of Obstetrics and Gynecology, Yeungnam University College of Medicine, Daegu, Korea.
Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
J Yeungnam Med Sci. 2023 Nov;40(Suppl):S87-S92. doi: 10.12701/jyms.2023.00108. Epub 2023 Apr 25.
Diffuse large B-cell lymphoma (DLBCL) is a subtype of non-Hodgkin lymphoma (NHL) and is estimated to account for approximately 30% of all NHL cases. NHL can also occur in the female genital tract and accounts for approximately 1.5% of all NHL cases. Many doctors have difficulty diagnosing or treating vulvar DLBCL because of its very low prevalence. A 55-year-old woman presented with a solid mass on the right side of the vulva. No significantly enlarged lymph nodes were observed in the inguinal region. She underwent excisional biopsy at our institution. DLBCL was diagnosed based on histological examination. According to the Hans algorithm, the lesion was diagnosed as a non-germinal center B-cell-like subtype. The patient was referred to a hematologic oncologist. The disease stage was classified as IE according to the Ann Arbor staging classification. The patient received four cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone and localized radiation therapy with 36 Gy in 20 fractions. She showed complete remission and maintained this status on the latest computed tomography scan. Gynecologists should rule out lymphoma in patients presenting with a vulvar mass.
弥漫性大B细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤(NHL)的一种亚型,估计约占所有NHL病例的30%。NHL也可发生于女性生殖道,约占所有NHL病例的1.5%。由于外阴DLBCL的发病率极低,许多医生在诊断或治疗该病时存在困难。一名55岁女性患者,外阴右侧出现实性肿块。腹股沟区未观察到明显肿大的淋巴结。她在我们机构接受了切除活检。根据组织学检查诊断为DLBCL。根据汉斯算法,该病变被诊断为非生发中心B细胞样亚型。患者被转诊至血液肿瘤学家处。根据Ann Arbor分期分类,疾病分期为IE期。患者接受了四个周期的利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松龙化疗,并接受了20次分割、共36 Gy的局部放射治疗。她显示完全缓解,在最新的计算机断层扫描中维持了这一状态。妇科医生应在出现外阴肿块的患者中排除淋巴瘤。