Introduction:

Primary lymphoma of the uterine cervix is a rare disease, with nonspecific symptoms, that seldom alters Pap smear results since it develops in the cervical stroma. Chemotherapy, radiation therapy, and surgery, as well as their combination, are some of the medical options available for treatment. The unique location of the lymphoma in the cervix is considered a good prognostic factor.

Case presentation:

A 49-year-old female patient consulted due to pelvic pain and vaginal discharge and bleeding. She underwent a colposcopy due to cytology findings of ASC-H (atypical squamous cells that do not exclude high-grade squamous intraepithelial lesions). The biopsy reported diffuse large B-cell lymphoma, which was initially treated with three cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, and was then switched to two cycles with rituximab, ifosfamide, carboplatin and etoposide due to a poor response with the first scheme. A new biopsy was performed after the last cycle of chemotherapy with a report of endocervical polyp and abundant clusters of glandular cells with focal atypia. Post-treatment diagnostic imaging studies reported concentric thickening of the cervix-vagina junction. Seven years after being diagnosed with lymphoma, another biopsy was performed. The result was negative for dysplasia or malignancy. At the time of writing this case report, 10 years after diagnosis, the patient is asymptomatic and disease-free.

Conclusions:

Primary lymphoma of the uterine cervix is an unusual condition that is rarely detected through an abnormal Pap smear result, as in this case. A colposcopy was done because of this finding, confirming the diagnosis of diffuse large B-cell lymphoma. This case report describes the satisfactory evolution of the patient and disease-free survival after 10 years.

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