Intravascular Large B-Cell Lymphoma of the Uterus: A Case with Favorable Clinical Outcome

Intravascular lymphoma (IVL) of the uterus, a rare manifestation of malignant lymphoma, was diagnosed in a 71-year-old woman, who had fever, edema, and genital bleeding. Only 4 cases of uterine IVL have been reported in detail in the literature in English, to the author’s knowledge. The patient was...

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Bibliographic Details
Published in:International journal of surgical pathology 2011-10, Vol.19 (5), p.672-676
Main Authors: Yamamoto, Tomoko, Morita, Kazuo, Iriyama, Noriyoshi, Wakui, Kiyotaka, Hiroi, Atsuko, Sawada, Tatsuo, Masuda, Akihiro, Kobayashi, Makio
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Combined Modality Therapy
Diabetes Mellitus
Female
Humans
Hypertension - complications
Hysterectomy
Immunohistochemistry
Lymphoma, Large B-Cell, Diffuse - metabolism
Lymphoma, Large B-Cell, Diffuse - pathology
Lymphoma, Large B-Cell, Diffuse - therapy
Ovariectomy
Salpingectomy
Uterine Neoplasms - metabolism
Uterine Neoplasms - pathology
Uterine Neoplasms - therapy
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Summary:Intravascular lymphoma (IVL) of the uterus, a rare manifestation of malignant lymphoma, was diagnosed in a 71-year-old woman, who had fever, edema, and genital bleeding. Only 4 cases of uterine IVL have been reported in detail in the literature in English, to the author’s knowledge. The patient was treated with total hysterectomy with bilateral salpingo-oophorectomy, accompanied by subsequent chemotherapy in combination with rituximab. Preoperative endometrial cytology and biopsy showed atypical lymphocytes intermingled with nonneoplastic epithelial cells. Intravascular proliferation of atypical lymphocytes was detected by histological examination of the resected materials, in which almost the entire uterine structure, including a large endometrial polyp, ovaries, and uterine tubes were involved. Immunohistochemically, tumor cells were positive for CD20 and CD79a and negative for CD5 and CD10. In situ hybridization for Epstein-Barr virus was negative. IVL generally has a poor prognosis. However, in the present case, the patient has been disease free for at least 51 months, and a favorable outcome can be expected.
ISSN:1066-8969
1940-2465
DOI:10.1177/1066896909346273