Forooshani Melika, Findley John, Yan Lucas, Zhang Ruonan, Dewdneym Summer, Ladanyi Andras, Yan Lei
Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL, USA.
Int J Surg Pathol. 2025 Aug 12:10668969251362445. doi: 10.1177/10668969251362445.
BackgroundLymphomas involving gynecologic organs often occur in the ovaries, and uterine cervix. Uterine corpus, vagina, and vulva are less common locations involved. Although female genital tract lymphomas are uncommon, it is important for the gynecologists and pathologists to be aware of this entity as it potentially could be the first presenting location of lymphoma or involved secondarily.MethodsPathology of lymphomas first diagnosed in and secondarily involving gynecologic organs from January 2005 to January 2024 were retrieved from our institution's pathology databases, and their clinicopathological features were reviewed.ResultsA total of 19 patients with lymphomas involving the gynecological organs were identified with 17 patients being first-time diagnosed with lymphomas on gynecologic surgical pathology specimens and 2 patients with prior history of lymphoma. The average age of patients with lymphoma diagnosed initially in the gynecologic tract was 59.2 years (range 20-83 years). The two patients with prior lymphoma histories had diffuse large B-cell lymphomas (DLBCL) with one transformed from prior retroperitoneal low-grade follicular lymphoma. The cervix was the most frequent location of first-time diagnosed lymphomas, comprising 8 of 17 specimens (47%), followed by bilateral ovaries and fallopian tubes (41%), endomyometrium (12%), and vagina (6%). The types of first diagnosed gynecologic lymphomas were DLBCL (65%), follicular lymphoma (18%), lymphoplasmacytic lymphoma (6%), Burkitt lymphoma (6%) and extranodal marginal zone B-cell lymphoma (MZBCL) (6%). When the criteria of defining primary gynecologic lymphomas were applied, 7 of 17 first-time diagnosed lymphomas in the gynecologic tract were actually primary gynecologic lymphomas without distant disease, peripheral blood or bone marrow involvement, including 5 cervical primary, one endometrial primary and one vaginal primary lymphoma.ConclusionOur study confirmed that the most common lymphomas involving the gynecologic tract were DLBCL and follicular lymphoma, with rare incidence of Burkitt lymphoma, extranodal MZBCL and lymphoplasmacytic lymphoma. Misdiagnosing gynecologic lymphomas as high-grade/undifferentiated carcinoma or sarcoma is a real risk for surgical pathologist, especially during frozen sections.
背景
累及妇科器官的淋巴瘤常发生于卵巢和子宫颈。子宫体、阴道和外阴较少受累。尽管女性生殖道淋巴瘤并不常见，但妇科医生和病理学家了解这一疾病实体很重要，因为它可能是淋巴瘤的首发部位或继发受累部位。
方法
从我们机构的病理数据库中检索2005年1月至2024年1月首次诊断于并继发累及妇科器官的淋巴瘤的病理资料，并对其临床病理特征进行回顾。
结果
共确定19例累及妇科器官的淋巴瘤患者，其中17例在妇科手术病理标本上首次诊断为淋巴瘤，2例有淋巴瘤病史。最初在生殖道诊断为淋巴瘤的患者平均年龄为59.2岁（范围20 - 83岁）。2例有淋巴瘤病史的患者为弥漫性大B细胞淋巴瘤（DLBCL），其中1例由先前的腹膜后低级别滤泡性淋巴瘤转化而来。宫颈是首次诊断淋巴瘤最常见的部位，17例标本中有8例（47%），其次是双侧卵巢和输卵管（41%）、子宫内膜（12%）和阴道（6%）。首次诊断的妇科淋巴瘤类型为DLBCL（65%）、滤泡性淋巴瘤（18%）、淋巴浆细胞淋巴瘤（6%）、伯基特淋巴瘤（6%）和结外边缘区B细胞淋巴瘤（MZBCL）（6%）。当应用原发性妇科淋巴瘤的定义标准时，17例首次在生殖道诊断的淋巴瘤中有7例实际上是无远处疾病、外周血或骨髓受累的原发性妇科淋巴瘤，包括5例宫颈原发性、1例子宫内膜原发性和1例阴道原发性淋巴瘤。
结论
我们的研究证实，累及生殖道最常见的淋巴瘤是DLBCL和滤泡性淋巴瘤，伯基特淋巴瘤、结外MZBCL和淋巴浆细胞淋巴瘤的发病率较低。对于手术病理学家来说，将妇科淋巴瘤误诊为高级别/未分化癌或肉瘤是一个实际风险，尤其是在冰冻切片检查时。
