Primary malignant lymphoma of the uterus and broad ligament: a case report and review of literature

Abstract

Primary malignant lymphoma of the uterus and broad ligament is rare. Here, we present a rare case of primary diffuse large B-cell lymphoma (DLBCL) of uterus and broad ligament in a 63-year-old female. The patient presenting with lower abdominal distention was referred to our hospital. Subsequent abdominal and pelvic ultrasound revealed the presence of a large mass, which was highly suspected as subserosal uterine leiomyoma. A large tumor was found with unclear boundary with right posterior wall, broad ligament and bilateral adnexa during surgery. Her uterus and the tumor of a broad ligament and bilateral adnexa were all excised as a result. Postoperative pathological examination showed DLBCL in uterus and broad ligament. Further examinations excluded metastatic diseases, which supported the diagnosis of primary DLBCL of the uterus and broad ligament. The patient received six cycles of R-CHOP (21 days) regimen. During the 8 months follow-up, no evidence of disease recurrence was identified. As the prevalence of primary extranodal lymphoma is increasing, the details of this rare case may highlight the importance and facilitate treatment of similar diseases. A summary focusing on the presentation and prognosis as well as a review of current management is also discussed.

Keywords: diagnosis; diffuse large B-cell lymphoma; extranodal lymphoma; primary uterine and broad ligament lymphoma; therapy.

Figure 1

An ultrasound showed the presence of a large mass, measuring 15.9 cm ×12.0 cm ×8.6 cm (longitudinal [A] and transverse [B]), with no definite evidence of local infiltration and lymphadenopathy, which was highly suspected as subserosal uterine leiomyoma.

Figure 2

HE staining of the specimen (×200) (A), and immunohistochemical examination revealed CD10 (+) (B), CD20 (+) (C), Bcl-6 (+) (D), and suggested putative germinal center B-cell origin. Abbreviation: HE, hematoxylin.