PRIMARY LYMPHOMA OF THE ENDOMETRIUM - A REPORT OF 2 CASES DIAGNOSED ON CERVICOVAGINAL SMEARS

BACKGROUND: Primary lymphomas of the endometrium are extremely rare. D iagnosis is difficult, especially when the neoplasm is originally eval uated on a cervicovaginal smear. When lymphomas involve the endometriu m, the cervix is three times more likely to be the primary site rather than the endometrium. Two of the symptoms of primary lymphoma of the endometrium are abnormal vaginal bleeding and an abdominal or pelvic m ass. CASES: Case 2 was a 36-year-old, obese, black female with an abdo minal mass and recent onset of ascites. The second case was a 31-year- old, obese, black female with a history of menometrorrhagia. The cytol ogic findings in both cases revealed an individual cell population, hi gh nuclear/cytoplasmic ratio, small nucleoli and coarsely granular chr omatin with some chromatin clearing. Endometrial currettings showed a histologic pattern of malignant non-Hodgkin's lymphoma, diffuse, large cell type. Immunoperoxidase staining was positive for leukocyte commo n antigen. CONCLUSION: Two cases of lymphoma of the endometrium were d iagnosed first by a cervical cytologic smear, supported by a positive body cavity fluid in one case and histology in both. The differential diagnoses included various inflammatory lesions, small cell carcinoma, endometrial stromal sarcoma and granulocytic sarcoma.