Lymphoma-like Lesion of the Uterine Cervix

Abstract

Lymphoma-like lesion of the female genital tract is rare. We report 12 cases of lymphoma-like lesions of the cervix in patients ranging from 27-54 years of age (mean 41). The commonest clinical presentation was post-coital bleeding (8), which was followed by vaginal bleeding (2) and leukorrhagia (4). Grossly, the lesions were either polypoid (8) or ulcerated (4). On histological examination, the lesions were eroded and involved the superficial mucosa 2-12 mm (mean 4 mm) in depth. They comprised sheets of dense populations of predominantly large lymphoid cells admixed with small lymphocytes, plasma cells, and neutrophils. Follicle formation was occasionally seen. Immunostaining revealed the majority of the large cells were B cells (CD20(+), CD79a(+)) with no aberrant CD5 and CD43 expression. The lymphoid cells in the follicle were CD10(+) and bcl6(+) but negative for bcl-2. Cyclin D1 was negative. There was no immunoglobulin light chain restriction and polymerase chain reaction for T cell receptor-gamma chain gene and immunoglobulin heavy chain gene demonstrated polyclonal patterns. In situ hybridization for EBER and high risk HPV 6/11 and 16/18 were negative. All patients were well with one case developing local recurrence in the follow-up period up to 7 years.