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Leukemia / lymphoma

Topic Completed: 1 September 2016

Minor changes: 25 February 2019

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PubMed Search: Uterus [title] Leukemia lymphoma

Vijay Shankar, M.D.
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Cite this page: Shankar V. Leukemia / lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusleukemialymphoma.html. Accessed May 26th, 2020.
Definition / general
  • Primary malignant lymphoma of the uterus is extremely rare
  • Most are Non Hodgkin lymphoma
    • Diffuse large B cell lymphoma is the most common subtype
    • NK / T cell lymphoma, plasmablastic lymphoma, peripheral T cell lymphoma and Burkitt lymphoma have also been reported
    • Low grade endometrial lymphoma is rare (Am J Surg Pathol 1997;21:187)
  • Hodgkin lymphoma is extremely rare
  • Metastasis of lymphoma to uterus has been reported
  • Uterus can also be involved in leukemia
  • Large cell lymphoma and granulocytic sarcoma resemble endometrial stromal sarcoma
Essential features
  • Primary malignant lymphoma of the female genital tract is extremely rare
  • Non Hodgkin lymphoma is the most common type
  • Vaginal bleeding is the most common presenting symptom
  • Immunohistochemical examination is necessary to determine the type and subtype of lymphoma
  • Accounts for 0.5% of extranodal lymphoma
  • Can occur in elderly women, although no age is exempt
Clinical features
  • Vaginal bleeding is the most common presenting symptom, followed by abdominal pain or urinary obstruction
  • Rarely presents with nonspecific symptoms such as intermittent fever (Medicine (Baltimore) 2016;95:e3532), abdominal bloating, pressure, discomfort
  • Criteria for diagnosis of primary lymphoma by Fox and More (J Clin Pathol 1965;18:723)
    • Clinically confined to the uterus
    • No evidence of leukemia
    • A fairly long interval between any prior lymphoma and the current uterine tumor
Prognostic factors
  • Depends on tumor stage, location and subtype
  • Low stage tumors: usually involve cervix, 5 year survival 83%
  • High stage tumors: usually involve uterine corpus, 5 year survival 29%
Case reports
  • Combined surgical resection, radiation therapy and chemotherapy
Gross description
  • Poorly circumscribed mass of variable size, with or without necrosis
  • May be diffuse involvement or infiltration of adjacent structures
Gross images

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Poorly circumscribed mass

Microscopic (histologic) description
  • Microscopic findings vary by lymphoma subtype
  • Diffuse large B cell lympoma
    • May be vaguely nodular
    • Sheets of large neoplastic cells infiltrate deeply in stroma, frequently with interspersed residual collagen bundles
    • Preserved bundles of smooth muscle may be pushed apart by sheets of lymphoma
    • Cells are moderate to large round cells with pleomorphic vesicular nuclei and prominent nucleoli
    • Frequent mitotic figures
Microscopic (histologic) images

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Diffuse large B cell lymphoma

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Primary extranodal NK/T cell lymphoma, nasal type

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Hodgkin lymphoma

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Acute lymphoblastic leukemia

Positive stains
Additional references
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