title: Florid reactive lymphoid hyperplasia (lymphoma-like lesion) of the uterine cervix.
abstract: Lymphoma-like lesion (LLL) of the female genital tract is an older term in the literature that describes a florid reactive lymphoid proliferation that can be misinterpreted as lymphoma. Multiple causes of LLL have been suggested but most cases remain unexplained. We describe the clinicopathologic features of 6 patients with LLL involving the uterine cervix. Five patients presented with abnormal Papanicolaou test (Pap smear), and 3 patients had a biopsy procedure performed prior to detection of LLL in a loop electrosurgical excision procedure (LEEP). In each specimen, surface epithelial erosion was associated with a superficial, polymorphous lymphoid infiltrate with numerous scattered large cells, without cellular necrosis or sclerosis. Squamous dysplasia was present in 4 patients. Immunohistochemical studies revealed a mixed population of B- and T-lymphoid cells. T-cells were more numerous but B-cells and formed aggregates or sheets in areas. The large cells were predominantly B-cells positive for CD20 and negative for CD3 in all cases. CD30 was positive 3 cases, and Epstein-Barr virus-encoded RNA was positive in 3 cases. Assessment for clonality in 1 patient using polymerase chain reaction (PCR) methods revealed monoclonal immunoglobulin heavy chain (IgH) gene rearrangements. At last clinical follow-up there was no evidence of progressive or systemic disease. We conclude that LLL of the cervix has a number of etiologies and that a prior surgical procedure, present in 3 patients in this study, is another possible etiology. As has been reported by others, monoclonal IgH gene rearrangements can be detected in this entity which has a benign clinical course.
authors: Department of Pathology and Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA. pramalingam@mdanderson.org
authors: Preetha
authors: P
authors: Ramalingam
authors: Pablo
authors: P
authors: Zoroquiain
authors: José R
authors: JR
authors: Valbuena
authors: Bonnie L
authors: BL
authors: Kemp
authors: L Jeffrey
authors: LJ
authors: Medeiros
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D008223:Lymphoma / Q000473:pathology; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D019310:Pseudolymphoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D055815:Young Adult
chemical_list: D007143:Immunoglobulin Heavy Chains