Obstetrics and Gynaecology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India.
Obstetrics and Gynaecology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
BMJ Case Rep. 2024 Apr 2;17(4):e258313. doi: 10.1136/bcr-2023-258313.
Involvement of the cervix with acute lymphoblastic leukaemia (ALL) is extremely rare. In this case report, we discuss an unmarried woman in her early 20s, who presented in the emergency with lower abdominal pain and irregular vaginal bleeding for 1 month. Clinical examination and imaging revealed a large cervical mass probably neoplastic with obstructive uropathy. On evaluation, she was diagnosed incidentally with CALLA-positive precursor B cell ALL in peripheral blood flow cytometry. Involvement of B cell ALL in cervical mass was confirmed by histopathological examination of cervical biopsy and immunohistochemistry markers. Her history was not suggestive of signs and symptoms pertaining to leukaemia. Literature is sparse with only a few cases reporting cervical leukaemic infiltration. The present case report is a rarest case where the primary/initial presentation of precursor B cell ALL was seen with cervical involvement and obstructive uropathy mimicking characteristics of advanced cervical malignancy.
急性淋巴细胞白血病(ALL)累及宫颈极其罕见。在本病例报告中,我们讨论了一位 20 岁出头的未婚女性,因下腹疼痛和不规则阴道出血 1 个月而到急诊就诊。临床检查和影像学检查显示宫颈有一个可能为肿瘤性的大肿块,伴有尿路梗阻。评估时,她意外地在外周血流式细胞术中被诊断为 CALLA 阳性前体 B 细胞 ALL。宫颈活检和免疫组织化学标志物证实了 B 细胞 ALL 累及宫颈。她的病史没有提示与白血病有关的症状和体征。文献报道很少,只有少数病例报告了宫颈白血病浸润。本病例报告是最罕见的病例,其中前体 B 细胞 ALL 的首发/初始表现为伴有宫颈浸润和尿路梗阻,类似于晚期宫颈癌的特征。