Case Report
Case Report of Diffuse Large B Cell Lymphoma of Uterine
Cervix Treated at a Semiurban Cancer Centre in North India
Vibhor Sharma,
1
Tapas Dora,
2
Mehul Patel,
3
Sankalp Sancheti,
4
and Epari Sridhar
5
1
Department of Medical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab 148001, India
2
Department of Radiotherapy, Homi Bhabha Cancer Hospital, Sangrur, Punjab 148001, India
3
Department of Radiodiagnosis, Homi Bhabha Cancer Hospital, Sangrur, Punjab 148001, India
4
Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, Punjab 148001, India
5
Department of Pathology, Tata Memorial Hospital, Mumbai 400012, India
Correspondence should be addressed to Vibhor Sharma; vibhor81@yahoo.co.in
Received 15 April 2016; Revised 12 July 2016; Accepted 13 July 2016
Academic Editor: Massimo Gentile
Copyright © 2016 Vibhor Sharma et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lymphoma of the uterine cervix is very rare. We report a case of difuse large B cell lymphoma (DLBCL) involving the uterine
cervix treated at a newly commissioned semiurban cancer centre in north India in 2015. Data for this study was obtained from the
hospital electronic medical records and the patient’s case fle. We also reviewed published case reports of uterine and cervical
lymphoma involving forty-one patients. We treated a case of stage IV DLBCL cervix with six cycles of R-CHOP (rituximab,
cyclophosphamide, doxorubicin, vincristine, and prednisolone) and intrathecal methotrexate followed by consolidation with
radiotherapy. Te patient showed complete response to chemotherapy. We conclude that, in advanced stage lymphoma involving
uterus and cervix, combination of chemotherapy and radiotherapy is efective in short term.
1. Introduction
Non-Hodgkin’s Lymphoma (NHL) afects extranodal sites in
one-third of cases. Te most commonly afected extranodal
sites are the gastrointestinal tract and skin. Rarely may female
reproductive organs be involved, most commonly ovary.
NHL of the cervix is extremely rare. In one series, cervix
was involved in 1 out of 730 cases of NHL and 1 out of 175
cases of extranodal lymphoma [1]. It is usually a high grade
B cell lymphoma [2] with abnormal vaginal bleeding as the
most common presenting symptom (60%) [3]. As cervical
lymphomas arise from the stroma rather than the mucosa,
hence cervical cytology is not very sensitive in recognizing
it. We report a case of DLBCL involving uterine cervix and
provide a review of literature of cervical lymphoma.
2. Case Presentation
A 61-year-old postmenopausal lady presented with bleeding
per vaginum and 6 kg weight loss in preceding 3 months. Her
performance status was 1 (ECOG scale). Local examination
revealed a 7 × 6 cm mass in the cervix and extending to lower
uterus and upper third of vagina, involving both parame-
tria. Rectal mucosa was uninvolved. Tere was no hep-
atosplenomegaly or lymphadenopathy. Contrast Enhanced
Computed Tomography (CECT) scan of chest abdomen and
pelvis revealed a 8.7 × 7.9cm mass in cervix with extension
into uterus and lower cervix, abutting the urinary bladder,
laterally involving parametrium, encasing right ureter caus-
ing mild-to-moderate hydronephrosis and posteriorly loss of
fat planes with rectum; bilateral external iliac lymph nodes
were enlarged (largest 2.5 × 2 cm); 1.3 cm mildly enhancing
mass in uncinate process of pancreas; multiple hypodense
lesions in both lobes of liver, largest being 1.5cm; and 2.8 ×
2.4 cm sof tissue deposit in subcutaneous plane in right lower
chest wall and multiple subcentimetric nodules in bilateral
lungs (Figures 1 and 2). Bone marrow and cerebrospinal fuid
were uninvolved. Cervical biopsy revealed difuse large B cell
lymphoma. On immunohistochemistry, cells tested positive
for CD20, MUM 1, and BCL 6; Mib 1 proliferation index was
70–80%. Viral serology for HIV, Hepatitis B surface antigen,
and Hepatitis C were negative. Afer complete diagnostic
Hindawi Publishing Corporation
Case Reports in Hematology
Volume 2016, Article ID 3042531, 4 pages
http://dx.doi.org/10.1155/2016/3042531