An unusual cause of postmenopausal bleeding.
BACKGROUND
Non-Hodgkin lymphoma usually presents with lymphadenopathy, fever, night sweats, and weight loss. Postmenopausal vaginal bleeding is a cardinal symptom of carcinoma of the endometrium or cervix but not one of non-Hodgkin lymphoma. Clinical awareness of this unusual mode of presentation is important.


METHODS
We report a case of non-Hodgkin lymphoma in a 60-year-old woman, who presented primarily with postmenopausal bleeding. Clinical examination revealed a "thickened" area on the posterior vaginal wall. Repeated vaginal biopsies showed fibrosis and inflammatory tissue only. Immunohistochemistry revealed non-Hodgkin lymphoma. This case highlights the diagnostic challenges such a complex case presents.


CONCLUSIONS
This case not only represents a case of non-Hodgkin lymphoma with genital involvement but also highlights the importance of diagnosis and management of such complex cases.
Wuntakal
Rekha
R
Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK. wrekhaw@rediffmail.com
Janga
Deepa
D
Satyanarayana
Durga
D
Reynolds
Karina
K
Hollingworth
Antony
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008796:Metrorrhagia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D017698:Postmenopause; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone