Juniper Publishers : Gynecological lymphoma in a developing community: Case report

       JUNIPER PUBLISHERS- JOURNAL OF GYNECOLOGY AND WOMEN’S HEALTH

                             Journal of Gynecology and Women’s Health-Juniper Publishers

 

Authored by Wilson Onuigbo*

 

Abstract

Lymphoma of the uterus is rare. Internet search revealed single or few examples from Poland, Spain, Australia, USA, India, China, and UK. Therefore, a case from Nigeria is deemed to be worthy of documentation. Epidemiologically, it differed from the others, whose ages ranged from 23 to 74, by presenting in a 13-year-old girl.

Keywords: Lymphoma; Uterus; Cervix; Age; Developing community

Introduction

Primary lymphoma of the uterine body and cervix is rare. Internet search revealed rare reports from Poland [1], Spain [2], Australia [3], USA [4], India [5], China [6], and UK [7]. The last listed case report was extensive thus: "We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametric with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy.” Accordingly, our case deserves reportage.

Case Report

EC, a 13-year-old girl, attended the Gynae Clinic of Dr Nnaemeka Osefo of The University of Nigeria Teaching Hospital, Enugu, Nigeria. She complained of painful lower abdominal swelling 2 weeks duration. On examination, a tender, firm enlarged uterus of 15/52 size. Exploratory laparotomy was first undertaken. As it was positive, total ophorectomy followed. Lymphoma was queried.

Dr Uchenna Ozumba clerked the specimen submitted. It was a uterine mass 15 x 8 cm with fallopian tube and 5cm ovary, which on section revealed 4 cm diameter whitish growth as well as corpus luteum with tiny cysts. The uterine tumor was thick, whitish and necrotic internally. A cuff-like flap was noted be in contiguity with the tumor.

The senior author, WO, found on microscopy that a necrosis prone, hyperchromatic growth with small round mitozing cells appeared in sheets without the starry-sky picture or Sternberg-Reed giant cells. There was no endometrium, cancer cells attacking even the innermost parts of the myometrium. The cervix was invaded in parts. The ovary was also involved. Her recovery was uneventful. Lymphoma with metastases was diagnosed.

Discussion

The rarity of gynecologic lymphoma is shown by the single or few cases published from all over the world [1-7]. Now, a Birmingham (UK) group maintained that the establishment of a histopathological pool facilitates epidemiological analysis [8]. Therefore, this report from such a pool that is situated in Enugu, Nigeria, in the domain of the Ibo or Igbo Ethnic Group was deemed to be research worthy [9].

In this context, the work done in USA stressed that the patients usually ranged in age from 23 to 74 years [4]. Accordingly, the epidemiological merit of the girl involved in this developing community is that teenage lymphoma may occur.

 

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