Uterine Diffuse Large B Cell Lymphoma Non-Germinal Center Type with Multiple Organs Involvement: A Case Report

Abstract

Primary lymphoma of the uterine and cervix are a rare disease with nonspecific symptoms. Our aim was to present the unusual case and increase the awareness of uterine lymphoma, a rare and aggressive disease of the female genital tract which have a poor prognosis. Case presentation: A 52-year-old woman, complaining of continuous vaginal bleeding for two weeks. The patient was presumed to have uterine leiomyoma at the primary health care and given medication to reduce bleeding. Five months later, the patient had recurrent vaginal bleeding, then admitted to a private hospital in Bandung with indicating suspicion of cervical malignancy. Histopathological examination from the cervical biopsy showed Burkitt's lymphoma. On immunohistochemistry examination, the result supported Diffuse Large B Cell Lymphoma. Then, the patient was referred to Dr. Hasan Sadikin General Hospital Bandung for radiotherapy and chemotherapy management. The patient's general condition and vital signs were within normal limits. There were no intrapulmonary metastases, cardiomegaly without pulmonary engorgement on chest X-ray examination. Ultrasound examination concluded the suspicion of the isthmus and cervical malignancy without any pelvic lymphadenopathy. One month later, the patient had Magnetic Resonance Imaging (MRI) that showed multiple lobulated lesions in the isthmus and cervix, pressing on the surrounding organs with multiple lymphadenopathies. Abdomen CT-Scan revealed intrahepatic, L2-5 vertebral, and multiple lymphadenopathy involvement. In July 2021, the patient complained of severe shortness of breath. On the paracentesis fluid, we found the malignant lymphoma tumor cells. Unfortunately, two weeks after the examination, the patient died. Conclusions: We present a rare, aggressive, and poor prognosis disease of uterine diffuse large B cell lymphoma non-germinal center type with multiple organs involvement.