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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
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M. Velu,

Teaching Hospital Kuliyapitiya, LK
About M.
Department of Haematology
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H. Salih,

Teaching Hospital Kuliyapitiya, LK
About H.
Department of Gynaecology and Obstetrics
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A. V. B. S. Inamaluwa,

Teaching Hospital Kuliyapitiya, LK
About A. V. B. S.
Department of Radiology
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S. Muhamdiram

Teaching Hospital Kurunegala, LK
About S.
Department of Radiology
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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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