de Miranda Lisa Erin, Uzabakiriho Bernard, Louw Melanie, Ngene Nnabuike Chibuoke
Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa.
Int Med Case Rep J. 2025 Mar 1;18:281-287. doi: 10.2147/IMCRJ.S500905. eCollection 2025.
Burkitt's lymphoma (BL) affecting the female genital tract is rare.
The aim of this paper is to report BL of the cervix in an HIV-positive patient to discuss the fatality of the condition and ways to mitigate it through advocacy for improved health care delivery in resource limited settings.
The patient was a 29-year-old woman, Para 1, with abnormal vaginal bleeding for a month and living with HIV and had a CD4 of 26 cells/μL. The histological examination of the cervical biopsy confirmed an extra-nodal BL. She had International Federation of Gynecology and Obstetrics (FIGO) stage 3B cervical cancer based on presence of hydronephrosis and pelvic wall involvement. The patient was reviewed at the oncology multidisciplinary meeting and required chemoradiation. There was delay in her management due to a long waiting list for chemoradiation at oncology unit in the referral center and the patient demised 43 days after diagnosis and did not receive the treatment.
This case suggests that women living with HIV who have BL should be fast-tracked for treatment as HIV viremia may worsen the prognosis of the malignancy. Following the encounter with the index patient an advocacy action plan has been made by the oncology multidisciplinary team to prioritize the treatment of women with aggressive histological types of cervical cancer.
A long waiting list for chemoradiation in low resource settings may delay management of advanced BL of the cervix. Inadequate cervical cancer screening and delays in diagnosis are other barriers to the care of women with aggressive cervical cancers in low resource settings. Systemic changes in healthcare delivery are therefore required in many low resource settings. Advocacy for patients particularly those with aggressive diseases using the index case as a point of reference is ideal and should be promoted in resource-limited settings to improve health care delivery.
累及女性生殖道的伯基特淋巴瘤（BL）较为罕见。
本文旨在报告一名HIV阳性患者的宫颈伯基特淋巴瘤，探讨该疾病的致死性以及在资源有限地区通过倡导改善医疗服务来缓解病情的方法。
患者为一名29岁经产妇，有一个月的异常阴道出血史，感染HIV，CD4细胞计数为26个/微升。宫颈活检的组织学检查确诊为结外伯基特淋巴瘤。根据存在肾积水和盆腔壁受累情况，她处于国际妇产科联合会（FIGO）3B期宫颈癌。患者在肿瘤多学科会议上接受了评估，需要进行放化疗。由于转诊中心肿瘤科室放化疗的等待名单过长，她的治疗延迟，患者在诊断后43天死亡，未接受治疗。
该病例表明，患有伯基特淋巴瘤的HIV感染女性应优先接受治疗，因为HIV病毒血症可能会恶化恶性肿瘤的预后。在遇到该索引患者后，肿瘤多学科团队制定了一项倡导行动计划，以优先治疗具有侵袭性组织学类型宫颈癌的女性。
在资源匮乏地区，放化疗的长等待名单可能会延迟晚期宫颈伯基特淋巴瘤的治疗。宫颈癌筛查不足和诊断延迟是资源匮乏地区侵袭性宫颈癌女性护理的其他障碍。因此，许多资源匮乏地区需要在医疗服务提供方面进行系统性变革。以索引病例为参考，为患者尤其是患有侵袭性疾病的患者进行倡导是理想的，应在资源有限地区推广以改善医疗服务。
