Lymphoma of the uterine cervix
Lymphoma of the uterine cervix is generally uncommon and when it does occur tends to present as cervical involvement with added background multi-organ disease rather than isolated primary cervical lymphoma 1. It is often considered part of the spectrum of uterine lymphoma.
In the western world, cervical lymphoma is thought to account for 0.008% of primary cervical tumours and 1 - 2% of extranodal lymphoma 2-3. It is however the most common site of lymphoma (primary or secondary) in the female genital tract.
While the age at presentation ranges widely can from 20 - 80 years, the median age is more closer to 40 - 60 years 1.
Common symptoms include vaginal bleeding, perineal discomfort and / or vaginal discharge. Patients may also present with an asymptomaic pelvic mass.
Cervical cytology is often normal as these tumours arise from cervical stroma, and squamous epithelial lining is preserved initially. A deep cervical biopsy is essential for diagnosis.
Diffuse uterine enlargement is the most common appearance. Less commonly, there may be a polypoidal or multinodular mass or a submucosal mass mimicking leiomyoma. In patients with multiorgan disease the pattern of change may be typical of lymphoma, allowing a confident pre-biopsy diagnosis
Considered non specific on CT and can have similar findings to other pelvic malignancies 6. CT may have place is assessing the extent of disease within the abdomen, pelvis and beyond..
As with uterine lymphoma in general MR imaging features non specific and can at times closely resemble that of adenocarcinoma of the cervix.
Lesions can be large while signal within the tumour is thought to be relatively homogeneous.
It has been reported that cervical lymphoma is best defined on T2 weighted images or contrast-enhanced T1 weighted images 7.
Signal characteristics include
- T1 - generally tends to be hypo-intense 2
- T2 - generally tends to be hyper-intense 2
MR imaging findings of a preserved cervical epithelium in the presence of extensive involvement of the cervical stroma may also be a suggestive feature 2.
Treatment and prognosis
Cervical lymphoma is usually treated with chemotherapy alone or in combination with irradiation or surgery. Prognosis generally tends to be favourable (especially compared with other cervical malignancies).
- 1. Thyagarajan MS, Dobson MJ, Biswas A. Case report: appearance of uterine cervical lymphoma on MRI: a case report and review of the literature. Br J Radiol. 2004;77 (918): 512-5. doi:10.1259/bjr/58044417 - Pubmed citation
- 2. Okamoto Y, Tanaka YO, Nishida M et-al. MR imaging of the uterine cervix: imaging-pathologic correlation. Radiographics. 23 (2): 425-45. doi:10.1148/rg.232025065 - Pubmed citation
- 3. Sala E, Wakely S, Senior E et-al. MRI of malignant neoplasms of the uterine corpus and cervix. AJR Am J Roentgenol. 2007;188 (6): 1577-87. doi:10.2214/AJR.06.1196 - Pubmed citation
- 4. Yokoyama Y, Sato S, Xiao YH et-al. Primary non-Hodgkin's lymphoma of the uterine cervix. Arch. Gynecol. Obstet. 2001;265 (2): 108-11. Arch. Gynecol. Obstet. (link) - Pubmed citation
- 5. Bode MK, Tikkakoski T, Johansson J et-al. Lymphoma of the cervix. Imaging and transcatheter arterial embolization. Acta Radiol. 2002;43 (4): 431-2. - Pubmed citation
- 6. Miketic LM, Carroll R, Harris NL et-al. Computed tomography in the evaluation of lymphoma of the uterine cervix. J Comput Tomogr. 1988;12 (2): 154-8. - Pubmed citation
- 7. Eurorad teaching files : Case 6230
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Lymphoma of the cervix||✗|
|Cervical involvement with lymphoma||✗|
|Uterine cervical lymphoma||✗|