Nodular lymphocyte predominant Hodgkin's lymphoma of the cervix: A case report of a rare entity

Abstract

► The clinical presentation of a case of NLPHL involving the uterine cervix. ► The immunohistochemical characteristics, the management and outcome of the described case. ► A brief review of the literature on current treatment strategies of early-stage NLPHL.

Keywords: Nodular lymphocyte predominant Hodgkin's lymphoma; Uterine cervix.

Fig. 4

Lymphocytic and histiocytic cells were strongly positive for CD20 (a), BOB-1 (b) and OCT-2 (c). (d) CD3 + T-lymphocytes surrounding L&H cells, forming rosettes (× 1000).

Fig. 1

(a) Contrast-enhanced computed tomography (CT) of a 54-year-old woman who presented with vaginal bleeding with remote history of subtotal hysterectomy with evidence of a large tumour of the residual cervix on pelvic examination. It shows an 8-cm cervical mass with smooth borders (solid long white arrow), a left external iliac lymph node (LN) (black arrow), a right external iliac LN (dashed white arrow), and a right internal iliac LN (solid short white arrow). (b) Positron emission tomography-CT scan showing increased metabolic activity in cervical mass (black arrow), a right internal iliac LN (solid white arrow) and a left external iliac lymph node (LN) (dashed white arrow).

Fig. 2

(a) Endocervical curettage showing cervical glands surrounded by a dense lymphocytic infiltrate (haematoxylin and eosin × 100). (b) Focally, a vaguely nodular growth pattern of the lymphoid cells was noted (haematoxylin and eosin × 100).

Fig. 3

(a) Uterine cervix biopsy showing a cervical gland surrounded by a mixture of large lymphoid cells and benign-appearing small lymphocytes (haematoxylin and eosin × 400). (b) Uterine cervix biopsy showing the presence of large abnormal-appearing lymphoid cells with polylobulated nuclei (popcorn cell), highly suggestive of lymphocytic and histiocytic Reed–Sternberg cells (haematoxylin and eosin × 1000).