Case Reports
Spindle cell variant of diffuse large B-cell lymphoma of the uterine cervix; a case report of a rare entity and a potential pitfall
Authors:
K. L. Jayasinghe ,
Teaching Hospital Kuliyapitiya, LK
About K. L.
Department of Histopathology
M. Velu,
Teaching Hospital Kuliyapitiya, LK
About M.
Department of Haematology
H. Salih,
Teaching Hospital Kuliyapitiya, LK
About H.
Department of Gynaecology and Obstetrics
A. V. B. S. Inamaluwa,
Teaching Hospital Kuliyapitiya, LK
About A. V. B. S.
Department of Radiology
S. Muhamdiram
Teaching Hospital Kurunegala, LK
About S.
Department of Radiology
Abstract
Introduction: Primary lymphomas involving the uterine cervix are rare. The spindle cell variant of diffuse large B-cell lymphoma (sDLBCL) occurring in the uterine cervix is extremely rare.
Case report: This is a 57-year-old woman, who presented with acute retention of urine. Clinical examination revealed a lesion obliterating the external os of the cervix. The ultrasound scan (USS) and contrast enhanced computerised tomography (CE-CT) confirmed the presence of a cervical mass with parametrial invasion. The cervical biopsy revealed an invasive tumour with a spindle cell morphology. Positive staining of tumour cells with immunohistochemical markers LCA and CD20 and a Ki-67 proliferation index of >90% was compatible with the sDLBCL. BCL6 positivity along with negative CD10 and IRF4/MUM1 was compatible with the germinal centre B-cell subtype. The bone marrow biopsy showed a tumour with similar immunomorphological features. The lymphoma was stage IV according to the Ann Arbor lymphoma staging system.
Discussion and conclusion: Owing to its rarity and histomorphology, the sDLBCL is often misdiagnosed as carcinosarcoma, melanoma or sarcoma on routine haematoxylin and eosin (H&E) stained sections. Therefore, appropriate immunohistochemical analysis is mandatory to distinguish sDLBCL from tumours with similar histomorphology. The prognosis of this rare tumour is not well- documented. Eight months after the initial presentation, the patient has completed six cycles of R-CHOP and is awaiting radiotherapy.
How to Cite:
Jayasinghe, K.L., Velu, M., Salih, H., Inamaluwa, A.V.B.S. and Muhamdiram, S., 2021. Spindle cell variant of diffuse large B-cell lymphoma of the uterine cervix; a case report of a rare entity and a potential pitfall. Journal of Diagnostic Pathology, 16(2), pp.32–37. DOI: http://doi.org/10.4038/jdp.v16i2.7793
Published on
31 Dec 2021.
Peer Reviewed
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