Primary diffuse large B-cell lymphoma of uterine cervix diagnosed by cytology and concurrent cervical biopsy: a case report and literatures reviews since 1980

Malignant lymphoma of the uterine cervix is rare with non-specific clinical presentation and is difficult to diagnose via cervical cytology. The current study presents a case of primary malignant lymphoma of the uterine cervix diagnosed via initial conventional smear cytology and subsequent cervical biopsy. We present a case of an 81-year-old woman with vaginal bleeding post-urination. The conventional smear cytology showed scattered large atypical lymphoid cells with necrotic debris. The concurrently biopsied specimen revealed large monotonous atypical lymphoid cells, which were immunoreactive for CD20 with high Ki-67 proliferative index, consistent with diffuse large B-cell lymphoma (DLBCL). Due to the transfer of the patient to another hospital, any other examinations associated with staging were not performed. Although rare, the likelihood of malignant lymphoma should be considered while screening for cervical cancer through cytology using Pap smear or conventional smear. Cytological screening may be useful for the early diagnosis of malignant lymphoma of the uterine cervix. Immediate and appropriate treatment can be initiated with a quick and accurate diagnosis. Herein, we report a case of primary uterine cervical DLBCL and review the literatures comprising 106 cases studies with 255 cases of primary cervical lymphoma reported since 1980 including clinical and histological characteristics through MEDLINE database.

Uterine cervix; Lymphoma; Chemotherapy; Primary; B-cell

[1] Calli A, Rezanko T, Yigit S, Payzin B. Lymphoma of the cervix: a diagnostic pitfall on cervicovaginal smear. Journal of Cytology. 2012; 29: 213.

[2] Kosari F, Daneshbod Y, Parwaresch R, Krams M, Wacker H. Lymphomas of the female genital tract: a study of 186 cases and review of the literature. American Journal of Surgical Pathology. 2005; 29: 1512–1520.

[3] Sharma V, Dora T, Patel M, Sancheti S, Sridhar E. Case report of diffuse large B cell lymphoma of uterine cervix treated at a semiurban cancer centre in North India. Case Reports in Hematology. 2016; 2016: 1–4.

[4] Murata H, Nakamura H, Ohta Y, Kitamura M, Nakastuka S, Ishikawa J, et al. Two cases of spindle cell variant diffuse large B-cell lymphoma of the uterine cervix. Gynecologic Oncology Reports. 2020; 33: 100611.

[5] Mohammed Saeed D, Patel P, Guzman G, Ni H. A case of classic hodgkin lymphoma involving the uterine cervix presenting as vaginal spotting. Cureus. 2020; 12: e8889.

[6] Del M, Angeles MA, Syrykh C, Martínez-Gómez C, Martínez A, Ferron G, et al. Primary B-cell lymphoma of the uterine cervix presenting with right ureter hydronephrosis: a case report. Gynecologic Oncology Reports. 2020; 34: 100639.

[7] Gui W, Li J, Zhang Z, Wang L, Zhao J, Ma L, et al. Primary hematological malignancy of the uterine cervix: a case report. Oncology Letters. 2019; 18: 3337–3341.

[8] Roberts ME, Cottrill HM. A case of primary cervical lymphoma in a patient with abnormal uterine bleeding. Gynecologic Oncology Reports. 2018; 26: 105–107.

[9] Koyanagi T, Kondo H, Toyama A, Ando M, Imaoka S, Inamura M, et al. Malignant lymphoma of the uterine cervix presumptively diagnosed by Pap smear: a case report. Oncology Letters. 2018; 15: 6678–6680.

[10] Yang G, Deisch J, Tavares M, Haixia Q, Cobb C, Raza AS. Primary B-cell lymphoma of the uterine cervix: presentation in Paptest slide and cervical biopsy. Diagnostic Cytopathology. 2017; 45: 235–238.

[11] Takimoto T, Maegawa S, Tatsumi H, Nagoshi H, Chinen Y, Shimura Y, et al. Extranodal marginal zone lymphoma of the uterine cervix with concomitant copy number gains of the MALT1 and BCL2 genes: a case report. Oncology Letters. 2017; 13: 3641– 3645.

[12] Mutoh T, Takatsuki H, Mannoji K, Kawamura K, Okura N, Ohshima K. Regression of uterine cervical diffuse large B-cell lymphoma transformed from mucosa-associated lymphoid tissue lymphoma subsequent to Chlamydia trachomatis eradication. Japanese Journal of Clinical Hematology. 2017; 58: 912–916.

[13] Kosari F, Niknejad N, Nili F, Jahanbin B, Malek M. Peripheral T-cell lymphoma presenting as a primary uterine cervix mass: a report of a rare case. International Journal of Gynecological Pathology. 2017; 36: 523–527.

[14] Cubo AM, Soto ZM, Cruz M, Doyague MJ, Sancho V, Fraino A, et al. Primary diffuse large B cell lymphoma of the uterine cervix successfully treated by combined chemotherapy alone. Medicine. 2017; 96: e6846.

[15] Zhou W, Hua F, Zuo C, Guan Y. Primary uterine cervical lymphoma manifesting as menolipsis staged and followed up by FDG PET/CT. Clinical Nuclear Medicine. 2016; 41: 590-593.

[16] Singh L, Madan R, Benson R, Rath GK. Primary non-Hodgkins lymphoma of uterine cervix: a case report of two patients. Journal of Obstetrics and Gynaecology of India. 2016; 66: 125–127.

[17] Regalo A, Caseiro L, Pereira E, Cortes J. Primary lymphoma of the uterine cervix: a rare constellation of symptoms. BMJ Case Reports. 2016; 2016: bcr2016216597.

[18] Omori M, Oishi N, Nakazawa T, Nakazawa K, Mitsumori T, Yuminamochi T, et al. Extranodal NK/T-cell lymphoma, nasal type of the uterine cervix: a case report. Diagnostic Cytopathology. 2016; 44: 430–433.

[19] Kojs ZJ, Niemiec M, Papuga-Fujak B, Kojs-Pasińska E, Sawicki W. Primary diffuse large B-cell lymphoma of the uterine cervix-case report. Ginekologia Polska. 2016; 87: 318–320.

[20] Fratoni S, Abruzzese E, Trawinska MM, Niscola P, de Fabritiis P, Santeusanio G. Primitive “spindle cell variant” (Sarcomatoid Vari- ant) diffuse large B-cell lymphoma of the uterine cervix. International Journal of Gynecological Pathology. 2016; 35: 593–597.

[21] Dobrosavljevic A, Skrobic M, Stanojevic D, Rakic S, Dragojevic Dikic S, Zecevic N. Primary non-Hodgkin lymphoma of the uterine cervix of a follicular type-case report. Journal of Obstetrics and Gynaecology. 2016; 36: 685–686.

[22] Wang G, Zhao W, Gao X, Zhang D, Wang G, Li W. Primary natural killer/T cell lymphoma of the cervix: case report and clinicopathological analysis. Taiwanese Journal of Obstetrics & Gynecology. 2015; 54: 71–74.

[23] Pather S, Philip V, Lakha AB, Wiggill TM, Suleman M, Patel M. An expanded spectrum of high-grade B-cell non-Hodgkin lymphomas involving the cervicovaginal region. International Journal of Gynecological Pathology. 2015; 34: 564–569.

[24] Li W, Wang R, Wang J, Chang K. Primary nodular lymphocytepredominant Hodgkin lymphoma of uterine cervix mimicking leiomyoma. Clinical Case Reports. 2015; 3: 349–352.

[25] Mouhajir N, Diakité A, Toulba A, Hemmich M, Saadi I, Elkacemi H, et al. Primary non-Hodgkin’s lymphoma of the uterine cervix: case report of long-term survival patient. Journal of Obstetrics and Gynecology of India. 2014; 64: 145–147.

[26] Mandato VD, Palermo R, Falbo A, Capodanno I, Capodanno F, Gelli MC, et al. Primary diffuse large B-cell lymphoma of the uterus: case report and review. Anticancer Research. 2014; 34: 4377–4390.

[27] Igwe E, Diaz J, Ferriss J. Diffuse large B cell lymphoma of the cervix with rectal involvement. Gynecologic Oncology Reports. 2014; 10: 1–4.

[28] Cao X, Li J, Zhang W, Duan M, Shen T, Zhou D. Patients with primary diffuse large B-cell lymphoma of female genital tract have high risk of central nervous system relapse. Annals of Hematology. 2014; 93: 1001–1005.

[29] Bellevicine C, Zabatta A, Malapelle U, Vetrani A, Troncone G. Diffuse large B-cell extranodal lymphoma of the uterine cervix: an incidental pap smear finding with histological and immunohistochemical correlation. Diagnostic Cytopathology. 2014; 42: 644– 646.

[30] Ahmad AK, Hui P, Litkouhi B, Azodi M, Rutherford T, McCarthy S, et al. Institutional review of primary non-hodgkin lymphoma of the female genital tract: a 33-year experience. International Journal of Gynecological Cancer. 2014; 24: 1250–1255.

[31] Hashimoto A, Fujimi A, Kanisawa Y, Matsuno T, Okuda T, Minami S, et al. Primary diffuse large B-cell lymphoma of the uterine cervix successfully treated with rituximabplus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy-a case report. Gan to Kagaku Ryoho. Cancer & Chemotherapy. 2013; 40: 2589–2592.

[32] Groszmann Y, Benacerraf BR. Sonographic features of primary lymphoma of the uterine cervix. Journal of Ultrasound in Medicine. 2013; 32: 717–718.

[33] Bull L, Knowles A, Ogden S, Boag F, Naresh KN, Bower M. Pri- mary cervical lymphoma: a rare presentation to a genitourinary medicine clinic. International Journal of STD & AIDS. 2013; 24: 587–589.

[34] Yalta T, Altaner S, Tastekin E, Usta U, Puyan F, Azatçam M. NonHodgkin′s lymphoma: a rare diagnosis on cervicovaginal cytology. Journal of Cytology. 2012; 29: 142.

[35] Vasudev DS, Kaler AK. Non-Hodgkin’s lymphoma of the uterine cervix. Online Journal of Health and Allied Sciences. 2012; 11: 13–15.

[36] Parnis J, Camilleri DJ, Babic D, Degaetano J, Savona-Ventura C. Lymphoma of the cervix. Case Reports in Hematology. 2012; 2012: 326127.

[37] Kanaan D, Parente DB, Constantino CPL, Souza RCD. Linfoma de colo de útero: achados na ressonância magnética. Radiologia Brasileira. 2012; 45: 167–169.

[38] Binesh F, Karimi zarchi M, Vahedian H, Rajabzadeh Y. Primary malignant lymphoma of the uterine cervix. BMJ Case Reports. 2012; 2012: bcr2012006675.

[39] Upanal N, Enjeti A. Primary lymphoma of the uterus and cervix: two case reports and review of the literature. The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2011; 51: 559– 562.

[40] Parva M, Lamb K, Savior DC, Gilman P, Belden M. Full-term pregnancy and vaginal delivery after treatment for non-Hodgkin’s lymphoma of the cervix and lower uterine segment: a case report. Journal of Obstetrics and Gynaecology Canada. 2011; 33: 620–624.

[41] Dyer MJS, Ye H, Isaacson PG. Primary lymphoma-like lesions of the uterine cervix; sheep in wolves’ clothing. British Journal of Haematology. 2011; 153: 791–794.

[42] Ustaalioglu BBO, Bilici A, Seker M, Canpolat N, Ozdemir N, Salepci T, et al. Primary non-Hodgkin lymphoma of cervix successfully treated with rituximab: positron emission tomography images before and after therapy: a case report. Leukemia Research. 2010; 34: e108–e110.

[43] Naki MM, Celik H, Api O, Ozdemir N, Bulut S, Unal O. Primary uterine lymphoma of the uterine cervix in advanced age. Turkish Journal of Hematology. 2010; 27: 219–220.

[44] Vidyasagar M, Baijal G, Vadiraja B, Fernandes D. Diffuse large B-cell lymphoma of the uterine cervix: a rare case managed novelly. Journal of Cancer Research and Therapeutics. 2009; 5: 140.

[45] Amna FA, Howell R, Raj S. Lymphoma of the cervix uteri. BMJ Case Reports. 2009; 2009: bcr0520091835.

[46] Okudaira T, Nagasaki A, Miyagi T, Nakazato T, Taira N, Kudaka W, et al. Primary diffuse large B-cell lymphoma of the uterine cervix-a case report. Gan to Kagaku Ryoho. Cancer & Chemotherapy. 2008; 35: 1423–1425.

[47] Köhler HF, Novik PR, Campos AHJFM. Lymphoma of the uterine cervix: report of two cases and review of the literature. Revista Brasileira De Ginecologia E Obstetricia. 2008; 30: 626–630.

[48] Hanprasertpong J, Hanprasertpong T, Thammavichit T, Kongk- abpan D, Tungsinmunkong K, Chandeying N. Primary nonHodgkins lymphoma of the uterine cervix. Asian Pacific Journal of Cancer Prevention. 2008; 9: 363–366.

[49] Coon D, Beriwal S, Swerdlow SH, Bhargava R. Mucosa-associated lymphoid tissue lymphoma of the cervix. Journal of Clinical Oncology. 2008; 26: 503–504.

[50] Ab Hamid S, Wastie ML. Primary non-Hodgkin’s lymphoma presenting as a uterine cervical mass. Singapore Medical Journal. 2008; 49: e73–e75.

[51] Signorelli M, Maneo A, Cammarota S, Isimbaldi G, Garcia Parra R, Perego P, et al. Conservative management in primary genital lymphomas: the role of chemotherapy. Gynecologic Oncology. 2007; 104: 416–421.

[52] Lu J, Li X, Zhu X. Distinction between lymphoma-like lesions and lymphoma of uterine cervix: a clinicopathologic study of 26 cases. Zhonghua Bing Li Xue Za Zhi. 2007; 36: 297–301.

[53] Lorusso D, Ferrandina G, Pagano L, Gagliardi ML, Scambia G. Successful pregnancy in stage IE primary non-Hodgkin’s lymphoma of uterine cervix treated with neoadjuvant chemotherapy and conservative surgery. Oncology. 2007; 72: 261–264.

[54] Korcum AF, Karadogan I, Aksu G, Aralasmak A, Erdogan G. Primary follicular lymphoma of the cervix uteri: a review. Annals of Hematology. 2007; 86: 623–630.

[55] Jiang X, Yang K, Peng Z, Xu L, Huang Q, Li Q. Clinicopathologic and immunohistochemical study of primary non-Hodgkin lymphoma of the female genital system. Zhonghua Fu Chan Ke Za Zhi. 2007; 42: 222–226.

[56] Semczuk A, Skomra D, Korobowicz E, Balon B, Rechberger T. Primary non-Hodgkin’s lymphoma of the uterine cervix mimicking leiomyoma: case report and review of the literature. Pathology, Research and Practice. 2006; 202: 61–64.

[57] González-Cejudo C, Martínez-Maestre MA, Peregrín-Alvarez I, Daza-Manzano C. Primary lymphoma of the cervix: unusual location for a common disease. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2006; 125: 268–269.

[58] Frey NV, Svoboda J, Andreadis C, Tsai DE, Schuster SJ, Elstrom R, et al. Primary lymphomas of the cervix and uterus: the University of Pennsylvania’s experience and a review of the literature. Leukemia & Lymphoma. 2006; 47: 1894–1901.

[59] Cantú de León D, Pérez Montiel D, Chanona Vilchis J. Primary malignant lymphoma of uterine cervix. International Journal of Gynecological Cancer. 2006; 16: 923–927.

[60] Van Renterghem N, De Paepe P, Van den Broecke R, Bourgain C, Serreyn R. Primary lymphoma of the cervix uteri: a diagnostic challenge. Report of two cases and review of the literature. European Journal of Gynaecological Oncology. 2005; 26: 36–38.

[61] Murad M, Akhtar W. Primary lymphoma of the cervix. Journal of College of Physicians and Surgeons Pakistan. 2005; 15: 364–365.

[62] Huang W, Chuang S, Eng H, Huanga C. Synchronous CIN 3 and cervical lymphoma: a case report and review of the literature. Pathology, Research and Practice. 2005; 201: 521–526.

[63] Goker BO, Bese T, Ilvan S, Yilmaz E, Demirkiran F. A case with multiple gynecological malignancies. International Journal of Gynecological Cancer. 2005; 15: 372–376.

[64] Garavaglia E, Taccagni G, Montoli S, Panacci N, Ponzoni M, Frigerio L, et al. Primary stage I–IIE non-Hodgkin’s lymphoma of uterine cervix and upper vagina: evidence for a conservative approach in a study on three patients. Gynecologic Oncology. 2005; 97: 214–218.

[65] Dursun P, Gultekin M, Bozdag G, Usubutun A, Uner A, Celik NY, et al. Primary cervical lymphoma: report of two cases and review of the literature. Gynecologic Oncology. 2005; 98: 484–489.

[66] Thyagarajan MS, Dobson MJ, Biswas A. Case report: appearance of uterine cervical lymphoma on MRI: a case report and review of the literature. British Journal of Radiology. 2004; 77: 512–515.

[67] Mikami Y, Maehata K, Fujiwara K, Sasano H. Squamous cell carcinoma of the uterine cervix in association with stage 0 chronic lymphocytic leukemia/small lymphocytic lymphoma. Gynecologic Oncology. 2004; 92: 974–977.

[68] Szánthó A, Bálega J, Csapó Z, Sréter L, Matolcsy A, Papp Z. Primary non-Hodgkin’s lymphoma of the uterine cervix successfully treated by neoadjuvant chemotherapy: case report. Gynecologic Oncology. 2003; 89: 171–174.

[69] Kahlifa M, Buckstein R, Perez-Ordoñez B. Sarcomatoid variant of B-cell lymphoma of the uterine cervix. International Journal of Gynecological Pathology. 2003; 22: 289–293.

[70] Hu Y, Feng FY, Zhang P, Zhou LQ, Zhang WH, Wang QL. Primary non-Hodgkin lymphoma in the female genital system: a report of 28 cases. Zhonghua Zhong Liu Za Zhi. 2003; 25: 486–489.

[71] Au WY, Chan BCP, Chung LP, Choy C. Primary B-cell lymphoma and lymphoma-like lesions of the uterine cervix. American Journal of Hematology. 2003; 73: 176–179.

[72] Rossi G, Bonacorsi G, Longo L, Artusi T, Rivasi F. Primary highgrade mucosa-associated lymphoid tissue-type lymphoma of the cervix presenting as a common endocervical polyp. Archives of Pathology & Laboratory Medicine. 2001; 125: 537–540.

[73] Liro M, Emerich J, Debniak J, Kobierski J, Mielcarek P. A rare case of non-Hodgkin’s lymphoma of the uterine cervix. Ginekologia Polska. 2001; 72: 27–30.

[74] Vang R, Medeiros LJ, Ha CS, Deavers M. Non-Hodgkin’s lymphomas involving the uterus: a clinicopathologic analysis of 26 cases. Modern Pathology. 2000; 13: 19–28.

[75] Pomares Arias E, Payeras Mas M, Conchillo Armendáriz MA, García González N, Prieto Valtueña J. Diffuse T-cell lymphoma of the cervix uteri: an unusual localization of an infrequent tumor. Anales De Medicina Interna. 2000; 17: 432–433.

[76] Kostopoulos IS, Barbanis SB, Kaloutsi VD, Papadimitriou CS. Synchronous occurrence of multiple malignant neoplasms in the uterus (adenocarcinoma of the endometrium, large B-cell lymphoma of the cervix). Pathology, Research and Practice. 2000; 196: 573–575.

[77] Wang PH, Chao KC, Lin G, Chao HT, Yuan CC, Ng HT. Primary malignant lymphoma of the cervix in pregnancy. a case report. Journal of Reproductive Medicine. 1999; 44: 630–632.

[78] Grace A, O’Connell N, Byrne P, Prendiville W, O’Donnell R, Royston D, et al. Malignant lymphoma of the cervix. an unusual presentation and a rare disease. European Journal of Gynaecological Oncology. 1999; 20: 26–28.

[79] Nasu K, Yoshimatsu J, Urata K, Miyakawa IA. Case of primary non-Hodgkin’s lymphoma of the uterine cervix treated by combination chemotherapy (THP-COP). Journal of Obstetrics and Gynaecology Research. 1998; 24: 157–160.

[80] Lee KM, Seah ES, Sethi VK. Primary non-Hodgkin’s lymphoma of the uterine cervix: case report of long-term survival of two patients treated with surgery and radiotherapy. Australasian Radiology. 1998; 42: 126–127.

[81] Kaito K, Otsubo H, Sekita T, Nishiwaki K, Masuoka H, Shimada T, et al. Primary non-Hodgkin’s lymphoma of the uterine cervix complicated by acute renal failure due to ureter obstruction. Japanese Journal of Clinical Hematology. 1998; 39: 463–465.

[82] Chandy L, Kumar L, Dawar R. Non-Hodgkin’s lymphoma presenting as a primary lesion in uterine cervix: case report. Journal of Obstetrics and Gynaecology Research. 1998; 24: 183–187.

[83] Biswal BM, Sharma A, Sharma MC, Prasad RR, Roy K, Rath GK. Malignant lymphoma of the uterine cervix: a case report and review of literature. Journal of the Indian Medical Association. 1997; 95: 434–440.

[84] Dhimes P, Alberti N, de Agustín P, Tubio J. Primary malignant lymphoma of the uterine cervix: report of a case with cytologic and immunohistochemical diagnosis. Cytopathology. 1996; 7: 204– 210.

[85] al-Talib RK, Sworn MJ, Ramsay AD, Hitchcock A, Herbert A. Primary cervical lymphoma: the role of cervical cytology. Cytopathology. 1996; 7: 173–177.

[86] Abbas MA, Birdwell R, Katz DS, Chang H, Ostrow K. Primary lymphoma of the cervix in a heart transplant patient. American Journal of Roentgenology. 1996; 167: 1136–1138.

[87] Winer N, Maisonneuve H, Magois C, Sagot P, Lopes P, Boog G, et al. Malignant non-Hodgkin’s lymphoma of the cervix. A case report. Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction. 1995; 24: 25–29.

[88] Reynaud P, Le Bouëdec G, Déchelotte P, Dauplat J, Chassagne J, Fonck Y. Rare tumors of the cervix: three case reports: rhabdomyosarcoma, granulocytic sarcoma and lymphoma. Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction. 1995; 24: 30–34.

[89] Makarewicz R, Kuzminska A. Non-Hodgkin’s lymphoma of the uterine cervix: a report of three patients. Clinical Oncology. 1995; 7: 198–199.

[90] Figuera JF, Rodríguez J, Rosales SA. Primary lymphoma of the uterine cervix. Sangre. 1994; 39: 58.

[91] Rodier JF, Ghnassia JP, Janser JC, Delahaye JF, Methlin A, Klein T. Non-Hodgkin’s malignant lymphoma of the cervix uteri. Journal De Chirurgie. 1993; 130: 554–555.

[92] Maryniak RK, Nasierowska-Guttmejer A. Primary malignant lymphoma of the uterine cervix. A clinicopathological evaluation of 3 cases. European Journal of Gynaecological Oncology. 1993; 14: 402–405.

[93] Aozasa K, Saeki K, Ohsawa M, Horiuchi K, Mishima K, Tsujimoto M. Malignant lymphoma of the uterus. Report of seven cases with immunohistochemical study. Cancer. 1993; 72: 1959–1964.

[94] Bou Saba C, Houkayem J, Afif N, Adaïmi F, Azouri J. Primary lymphoma of the uterine cervix. A case report and literature review. The Lebanese Medical Journal. 1992; 40: 207–210.

[95] Pasini F, Iuzzolino P, Santo A, Perini A, Sabbioni R, Zannoni M, et al. A primitive lymphoma of the uterine cervix. Case report. European Journal of Gynaecological Oncology. 1991; 12: 107–112.

[96] Muntz HG, Ferry JA, Flynn D, Fuller AF, Tarraza HM. Stage IE primary malignant lymphomas of the uterine cervix. Cancer. 1991; 68: 2023–2032.

[97] Sandvei R, Lote K, Svendsen E, Thunold S. Successful pregnancy following treatment of primary malignant lymphoma of the uterine cervix. Gynecologic Oncology. 1990; 38: 128–131.

[98] Ohta M, Mizuno K, Kaseki H, Iida S, Nishikawa Y, Ishihara T, et al. Three cases of malignant lymphoma of the cervix uteri. Nihon Sanka Fujinka Gakkai Zasshi. 1990; 42: 495–498.

[99] Murotsuki J, Yazaki S, Hayakawa S, Yamashita T. A case of malignant lymphoma of the uterine cervix. Japan Journal of Cancer Clinics. 1989; 35: 1716–1720.

[100] Khoury GG, Robinson A. Lymphoma of uterine cervix. European Journal of Surgical Oncology. 1989; 15: 65–67.

[101] Cardillo MR, Manente L, Ambrad O, D’Orazio A, Forte F, Santeusanio G. Immunohistochemical study in a case of primitive lymphoma of the uterine cervix. European Journal of Gynaecological Oncology. 1987; 8: 607–612.

[102] Cardillo MR, Forte F. The diagnostic value of cytology in a case of lymphoma of the uterine cervix. European Journal of Gynaecological Oncology. 1987; 8: 597–602.

[103] Taki I, Aozasa K, Kurokawa K. Malignant lymphoma of the uterine cervix. Cytologic diagnosis of a case with immunocytochemical corroboration. Acta Cytologica. 1985; 29: 607–611.

[104] Gharpure KJ, Mahesh D, Bhargava MK. Malignant lymphoma of the uterine cervix-a report of two cases with review of literature. Indian Journal of Cancer. 1985; 22: 296–302.

[105] Komaki R, Cox JD, Hansen RM, Gunn WG, Greenberg M. Malignant lymphoma of the uterine cervix. Cancer. 1984; 54: 1699–1704.

[106] Harris NL, Scully RE. Malignant lymphoma and granulocytic sarcoma of the uterus and vagina. A clinicopathologic analysis of 27 cases. Cancer. 1984; 53: 2530–2545.

[107] Hilal Z, Hartmann F, Dogan A, Cetin C, Krentel H, Schiermeier S, et al. Lymphoma of the cervix: case report and review of the literature. Anticancer Research. 2016; 36: 4931–4940.

[108] Cahill LA, Stastny JF, Frable WJ. Primary lymphoma of the endometrium. A report of two cases diagnosed on cervicovaginal smears. Acta Cytologica. 1997; 41: 533–538.