Primary high-grade mucosa-associated lymphoid tissue-type lymphoma of the cervix presenting as a common endocervical polyp

Lymphomas of the uterine cervix are uncommon neoplasms and typically appear as diffuse cervical enlargement. We describe a rare case of primary high-g rade lymphoma of mucosa-associated lymphoid tissue of the uterine cervix in a 46-year-old white woman. The tumor, incidentally disclosed at gynecologi cal examination, appeared as a single common polyp. Immunohistochemical inv estigation found the lesion to consist of a monomorphic CD20-positive infil trate of large blasts and rare intermingling centrocyte-like lymphoid cells . A dense area of monotypic (lambda light-chain restriction) plasma cells w as found beneath the endocervical mucosa; only a few scattered lymphoepithe lial lesions were present. The neoplastic cells did not stain for CD5, CD10 , CD23, CD43, or cyclin D1. A bone mar row biopsy displayed a paratrabecula r, centrocyte-like B-cell infiltration, but no lymphadenopathy was detected by instrumental examination (computed tomographic scan, magnetic resonance imaging). The tumor was successfully treated by multiagent chemotherapy fo llowed by total hysterectomy. To our knowledge, this case represents the se cond reported example of mucosa-associated lymphoid tissue-type lymphoma oc curring in the uterine cervix. We highlight the very unusual gross appearan ce of this case and emphasize the difficulty of interpreting lymphoid infil trates in the lower genital tract by microscopy.