Primary gynecological non-Hodgkin's lymphoma: A differential diagnosis of a pelvic mass

摘要

Primary Non-Hodgkin's lymphoma (NHL) can mimic gynecological malignancy, presenting as a pelvic mass in any organ of the female genital tract. Patients can present with elevated CA-125 and may lack the classical symptoms associated with lymphoma, such as fatigue, fever, night sweats and weight loss. We describe five patients that presented with primary NHL of the genital tract. Patients 1, 2, and 3 were not diagnosed pre-operatively, and underwent unnecessary cytoreductive surgery, while patients 4 and 5 were diagnosed by pre-operative biopsy. The diagnosis of primary pelvic lymphoma should be in the differential diagnosis of gynecological malignancies. Awareness of the disease and pre-operative diagnosis can be beneficial, as the patient may be able to avoid unnecessary staging operations and disease cytoreduction. Highlights ? Primary gynecological NHL can present as a pelvic mass in any female reproductive organ. ? Most patients lack the classical “B-cell” symptoms associated with lymphoma. ? Elevated CA-125 is a common finding and is associated with advanced disease and poorer prognosis. ? NHL is responsive to chemotherapy, thus surgical staging and cytoreduction are not indicated. ? Pre-operative biopsy of suspicious lesions can aide in diagnosis, and avoid unnecessary surgery.