Non-Hodgkin's lymphomas involving the uterus: A clinicopathologic analysisof 26 cases

Non-Hodgkin's lymphomas (NHL) involving the uterus may be either low-stage neoplasms that probably arise in the uterus (primary) or systemic neoplasms with secondary involvement. In this study, 26 NHL involving the uterus are reported. Ten cases were stage I, or II, and are presumed to be primary. T he mean age of patients at presentation was 55 years (range, 35 to 67 years ), and abnormal uterine bleeding was the most frequent complaint (six patie nts). Nine of 10 tumors involved the cervix Histologically, eight were diff use large B-cell lymphoma (DLBCL); one was follicle center lymphoma, follic ular, grade 1; and one was marginal zone B-cell lymphoma. At 5 years of cli nical followup, five of six patients were alive after treatment. In 12 case s, uterine involvement was part of a systemic disease at diagnosis, either stage III, or IV, The mean patient age at the time that uterine involvement was detected was 58 years (range, 22 to 75 years); 6 of 12 had abnormal ut erine bleeding. Six tumors involved both cervix and corpus, four corpus, an d two cervix Six were DLBCL; two were small lymphocytic lymphoma; three wer e follicle center lymphoma, follicular, grade 1 (two cases) or grade 2 (one case); and one was precursor T-cell lymphoblastic lymphoma. At 5 years of clinical follow-up, two of seven patients were alive after treatment. Four DLBCL arose in patients with incomplete clinical information; therefore, st age is unknown, We conclude that low-stage (presumably primary) uterine NHL are most commonly DLBCL, predominantly arise in the cervix, and cause abno rmal uterine bleeding. High-stage NHL are a heterogeneous group of B-cell n eoplasms that can involve the cervix or the corpus.