Uterus
Other tumors
Leukemia / lymphoma

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 19 September 2016, last major update September 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Uterus [title] Leukemia lymphoma
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
Epidemiology
  • Accounts for 0.5% of extranodal lymphoma
  • Can occur in elderly women, although no age is exempt
Sites
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
Diagnosis
  • 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
Radiology Images

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Primary lymphoma of the uterine cervix

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
Treatment
  • 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

Micro 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
Micro 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