Vagina
Malignant tumors
Lymphoma


Senior Author: Arzu Buyuk, M.D.
Shweta Gera, M.D.

Topic Completed: 1 June 2014

Revised: 26 February 2019

Copyright: 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Lymphoma [title] vagina

Shweta Gera, M.D.
Page views in 2018: 329
Page views in 2019 to date: 228
Cite this page: Gera S. Lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/vaginalymphoma.html. Accessed September 16th, 2019.
Definition / general
  • Primary vaginal lymphoma is rare with favorable prognosis and a good response rate
Terminology
Epidemiology
  • Through 2012, at least 63 patients with PNHLV have been reported in the English literature (Acta Haematol 2012;128:33)
  • Primary genital tract lymphomas are very rare, accounting for < 0.5% of all genital cancers, 1.5% of all non-Hodgkin lymphoma
  • Primary lymphoma of vagina is also very rare (Gynecol Oncol 2007;104:416)
  • Mean age at presentation is 47 years, range 19 - 79 years (Acta Haematol 2012;128:33)
Sites
  • Can involve any part of vagina
Etiology
Clinical features
  • Most common clinical presentation is vaginal bleeding, vaginal mass, vaginal discharge, dyspareunia and abdominal or pelvic pain
  • Rarely patients are asymptomatic
  • If diagnosed at early stage, B symptoms are rarely seen (Acta Haematol 2012;128:33, Gynecol Oncol 2007;104:416)
Diagnosis
Radiology description
  • Required to determine extent and stage of the disease
Radiology images

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MRI of pelvis

Prognostic factors
Case reports
Treatment
  • Treatment depends on stage of disease
  • Polychemotherapy is preferred therapy, with or without immunotherapy (e.g. rituximab), especially in young patients where fertility has to be preserved (Haematologica 2000;85:666, Gynecol Oncol 2007;104:416)
  • Usually (R-CHOP) regimen is preferred: rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone
  • Radiotherapy is often combined with chemotherapy depending on stage and patient age
  • Surgery has essentially no role in treatment (Acta Haematol 2012;128:33)
Clinical images

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Gross description
Gross images

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Contents of vaginal tumor

Microscopic (histologic) description
  • Submucosal diffuse infiltrate of medium to large cells with scant basophilic cytoplasm and round or pleomorphic and multilobulated nuclei, pale chromatin and small or medium nucleoli
  • Mitoses and necrosis are more frequent with higher grades (Acta Haematol 2012;128:33, Gynecol Oncol 2004;95:719)
  • Normal vaginal epithelium can be seen if not ulcerated
Microscopic (histologic) images

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Various stains

Cytology description
  • Atypical lymphoid cells are rarely found on Pap smears
  • Persistent finding of atypical or suspicious cells of unknown significance is usually followed by colposcopic examination and biopsy
Cytology images

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Various images

Positive stains
Negative stains
Differential diagnosis
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