NON-HODGKIN LYMPHOMA OF UTERINE CERVIX: CASE REPORT AND LITERATURE REVIEW

Case presentation: A 44-year-old patient presented with metrorrhagia. On specular examination, a polyp lesion was observed, measuring about 4cm, deflecting the cervix to the left and reaching the middle third of the vagina. There was also involvement of the left parametrium. Pathological examination showed nonspecific subacutecervicitis. She underwent4biopsies that showed similar Results: Immunohistochemistry demonstrated compatibility with diffuse large cell non-Hodgkin B lymphoma. Chest, abdomen and pelvis computed tomography (CT) examinations and bone marrow biopsy were requested. Cervical staging was defined as IIB. CT scans showed enlarged uterus and cervix and absence of lymph node enlargement. Bone marrow biopsy ruled out infiltration by neoplasia. 4 cycles of chemotherapy were performed with the CHOP regimen (cyclophosphamide, adriamycin, oncovin and prednisone). Consolidation radiotherapy with a dose of 36 Gy with 1.8 Gy fractions was chosen. It remains in outpatient follow-up, with no evidence of disease recurrence after 2 years. Discussion: Cervical lymphoma is a rare disease. Of these, about 25% are from extra-nodal involvement and 0.2% affects the uterus. The disease is observed in women between 20 and 80 years. Etiology is not fully elucidated. Presence of lymphoid cells is the main feature. The patient underwent 4 cervical biopsies that showed an inflammatory aspect, and the diagnosis was confirmed by immunohistochemistry. Staging follows the Ann Arbor protocol for extronadal lymphomas. In the reported case, treatment was performed with systemic chemotherapy and consolidation pelvic adjuvant radiotherapy. In most available studies, chemotherapy with CHOP combined with radiotherapy has shown good cure and disease-free survival outcomes. Final comments: The case of a woman with diffuse large cervical cell non-Hodgkin B lymphoma was described and the clinical and histological characteristics discussed. It is a rare disease that should be remembered as a differential diagnosis of apparently simple cases such as cervicitis. Further studies are needed to standardize conduct and treatment protocols. In most studies, chemotherapy with the CHOP regimen, whether or not associated with radiotherapy, has shown satisfactory Results.