子宫颈原发弥漫大B细胞淋巴瘤1例并文献复习

A Case of Primary Diffuse Large B-Cell Lymphoma of the Uterine Cervix and Review of the Literature

宫颈原发的非霍奇淋巴瘤十分罕见,因临床表现无特异性,常常与女性生殖系统其他恶性肿瘤混淆。弥漫大B细胞淋巴瘤是最常见的亚型,及时的诊断及干预治疗,患者预后通常良好。我们报道了1例原发宫颈弥漫大B细胞淋巴瘤的患者,她因为阴道触及赘生物并伴腹痛入院,行肿物的活检,诊断为弥漫大B细胞淋巴瘤。随后行骨髓穿刺排除了骨髓受累,PET/CT可见子宫颈62 × 74 mm软组织肿块,向上侵及子宫体,左侧宫旁间隙可见软组织密度斑片,侵及左侧附件,腹膜后腹主动脉左旁轻度增大淋巴结。结合她的检查,明确诊断为子宫颈原发弥漫大B细胞淋巴瘤,分期IIE期。治疗上给予R-CHOP方案化疗,在第三疗程结束时行PET/CT评估病情显示CR,继续给予患者4周期化疗。从明确诊断截至到目前我们随访了8月,患者疾病依然缓解。

Primary non-Hodgkin’s lymphoma of the cervix is very rare and is often confused with other malig-nant tumors of the female reproductive system because of the nonspecific clinical presentation. Diffuse large B-cell lymphoma is the most common subtype, and patients usually have a favorable prognosis with timely diagnosis and interventional therapy. We report a case of primary cervical diffuse large B-cell lymphoma in a patient who was admitted to the hospital for vaginal palpation of a bulky mass with abdominal pain and underwent biopsy of the mass, which led to the diagnosis of diffuse large B-cell lymphoma. Subsequently, a bone marrow aspiration was performed to rule out bone marrow involvement, and PET/CT revealed a 62 × 74 mm soft tissue mass in the cervix that invaded the uterine body upward, a soft tissue density patch in the left parietal space that invaded the left adnexa, and mildly enlarged lymph nodes on the left side of the retroperitoneal abdominal aorta. Combined with her examination, a definitive diagnosis of primary diffuse large B-cell lym-phoma of the uterine cervix with stage IIE was made. She was treated with R-CHOP regimen chem-otherapy, and at the end of the third course of treatment, PET/CT was performed to evaluate the disease showing CR, and the patient was continued to be given 4 cycles of chemotherapy. From the time of definitive diagnosis up to now we have followed the patient for 8 months and the patient is still in remission.