内容紹介
Primary Diffuse Large B-Cell Lymphoma of the Uterine Cervix Successfully Treated with Rituximab plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Chemotherapy―A Case Report
Summary
Primary malignant lymphoma of the uterine cervix is a rare disease, and the therapeutic strategy has not been clearly established. A 45-year old woman presented with vaginal bleeding and hypermenorrhea in January 2012. Physical examination revealed a mass in the pelvic cavity approximately the size of a neonate's head. Pelvic magnetic resonance imaging(MRI)showed a solid mass 11 cm in size in the uterine cervix with homogeneous low intensity on T1-weighted images, iso-high intensity on T2-weighted images, and heterogeneous iso-high intensity on gadolinium-diethylenetriaminepentaacetate(Gd-DTPA)-enhanced images. Multiple lymphadenopathy were also detected in the pelvis. The Papanicolaou smear indicated class 5 cervical cytology, and a subsequent histological examination by a punch biopsy of the cervix showed diffuse infiltration of medium- to large-sized mononuclear cells that stained positive for CD20 and CD79a and negative for CD3, CD5, and EBER. Bone marrow biopsy revealed no abnormality. Positron emission tomography-computed tomography(PET-CT)showed strong fluorodeoxyglucose(FDG)accumulation in the uterine cervix mass, and in the pelvic and right inguinal lymphadenopathy. The patient was diagnosed with diffuse large B-cell lymphoma of the uterine cervix, Ann Arbor stageⅡAE. She was successfully treated with 8 courses of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone(R-CHOP)chemotherapy, and maintains a complete remission.
要旨
症例は45歳,女性。2012年1月より血性帯下,過多月経を認め,4月に当院産婦人科受診。MRIにて子宮頸部にT1で低信号,T2で中等度の信号を示すφ11 cmの腫瘤と多数の骨盤内リンパ節腫脹を認め,PET/CTで同部位に強い集積を認めた。子宮頸部細胞診はclassⅤで,経膣的生検では中～大型単核球の浸潤を認め,CD20,CD79a陽性,CD3,CD5,EBER陰性であった。骨髄浸潤は認めなかった。びまん性大細胞型B細胞リンパ腫,病期ⅡAEと診断した。R-CHOP療法8コース終了後,完全寛解を維持している。子宮頸部原発悪性リンパ腫は節外性リンパ腫の0.5%とまれである。
目次
Summary
Primary malignant lymphoma of the uterine cervix is a rare disease, and the therapeutic strategy has not been clearly established. A 45-year old woman presented with vaginal bleeding and hypermenorrhea in January 2012. Physical examination revealed a mass in the pelvic cavity approximately the size of a neonate's head. Pelvic magnetic resonance imaging(MRI)showed a solid mass 11 cm in size in the uterine cervix with homogeneous low intensity on T1-weighted images, iso-high intensity on T2-weighted images, and heterogeneous iso-high intensity on gadolinium-diethylenetriaminepentaacetate(Gd-DTPA)-enhanced images. Multiple lymphadenopathy were also detected in the pelvis. The Papanicolaou smear indicated class 5 cervical cytology, and a subsequent histological examination by a punch biopsy of the cervix showed diffuse infiltration of medium- to large-sized mononuclear cells that stained positive for CD20 and CD79a and negative for CD3, CD5, and EBER. Bone marrow biopsy revealed no abnormality. Positron emission tomography-computed tomography(PET-CT)showed strong fluorodeoxyglucose(FDG)accumulation in the uterine cervix mass, and in the pelvic and right inguinal lymphadenopathy. The patient was diagnosed with diffuse large B-cell lymphoma of the uterine cervix, Ann Arbor stageⅡAE. She was successfully treated with 8 courses of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone(R-CHOP)chemotherapy, and maintains a complete remission.
要旨
症例は45歳,女性。2012年1月より血性帯下,過多月経を認め,4月に当院産婦人科受診。MRIにて子宮頸部にT1で低信号,T2で中等度の信号を示すφ11 cmの腫瘤と多数の骨盤内リンパ節腫脹を認め,PET/CTで同部位に強い集積を認めた。子宮頸部細胞診はclassⅤで,経膣的生検では中～大型単核球の浸潤を認め,CD20,CD79a陽性,CD3,CD5,EBER陰性であった。骨髄浸潤は認めなかった。びまん性大細胞型B細胞リンパ腫,病期ⅡAEと診断した。R-CHOP療法8コース終了後,完全寛解を維持している。子宮頸部原発悪性リンパ腫は節外性リンパ腫の0.5%とまれである。