Cervical lymphoproliferative disease:a clinicopathological analysis of three cases

ZHANG Bo; KANG Kai-fu; QU Zhao-fu

doi:10.3969/j.issn.1007-8096.2023.10.012

Abstract：Objective To investigate the clinicopathological features,immunophenotype,molecular characteristics,differential diagnosis,treatment and prognosis of cervical lymphomatoid lesions and primary cervical B-cell lymphoma.Methods A total of 3 cases of cervical lymphoproliferative disease were collected.Immunohistochemistry,EBER in situ hybridization and Ig gene rearrangement analysis were used to detect the clinicopathological features with review of relevant literature.Results In 2 cases of cervical biopsy,immunohistochemical staining showed that small cells expressed mature T and B cell antibodies,medium to large cells expressed CD30,Kappa/Lambda was non-light chain restricted expression,Ki-67 proliferation index was about 65%～80%,and p53 showed wild type.EBER in situ hybridization was negative.They were diagnosed with cervical lymphatic hyperplasia and cervical lymphomatoid disease(LLL)after negative clonal Ig gene rearrangement.In 1 case of cervix ulcerative tumor,immunohistochemistry showed diffuse positive expression of CD20 in tumor cells,but p53 showed wild-type.Ki-67 proliferation index was about 90%,and no tumor cells were found in bone marrow biopsy.The patient was pathologically diagnosed as primary diffuse large B-cell lymphoma of the cervix(CE-DLBCL).Conclusion Cervical LLL is a relatively rare self-restricted benign lymphoid reactive proliferative disease,which is easily misdiagnosed as malignant lymphoma and over-treated.CE-DLBCL is more rare,the diagnostic criteria are strict and the prognosis depends on accurate and timely diagnosis,clinical staging and treatment.