Primary natural killer/T-cell lymphoma of the cervix: a case report and literature review

Background: Non-Hodgkin lymphoma (NHL) involvement of the uterus is rare. Histologically, the majority of previously reported cases of NHL involving the female genital tract have been aggressive B-cell lymphomas, while natural killer (NK)/T-cell lymphoma involving the uterus is extremely rare. Case presentation: We report a case of primary cervical extranasal NK/T-cell lymphoma in a 36-year-old Chinese woman who complained of irregular vaginal bleeding. A computerized tomographic (CT) scan of the pelvis revealed a mass about 5 cm in size in the cervix with evidence of pelvic lymph node enlargement. Microscopic examinations showed prominent necrosis, angiocentric growth and diffuse infiltration by mediumto large-sized atypical lymphoid cells. The neoplastic cells were negative for CD20 and positive for cytoplasmic CD3, CD56, and granzyme B. In-situ hybridization showed that the tumor cells were positive for Epstein-Barr virus (EBV)-encoded small RNAs (EBERs). Based on these findings, the diagnosis of primary cervical extranasal natural killer (NK)/T-cell lymphoma was made. Four months after the chemotherapy and local radiation therapy, a mass lesion of the right orbit was observed by follow-up magnetic resonance imaging (MRI). In spite of intensive chemotherapy, the patient died of disease dissemination with an overall survival of 15 months. Conclusions: Due to its rarity and nonspecific clinical signs, uterine cervical lymphoma is sometimes a diagnostic challenge. The case described here may be of value in elucidating the biological behavior and natural history of NK/T-cell lymphoma.