title: An unusual uterine tumor with signet ring cell features.
abstract: In 2004, a 56-year-old woman was diagnosed with Stage IA follicular lymphoma in a cervical lymph node biopsy. The patient experienced total remission after local radiation therapy. In 2009, a control computed tomography scan evidenced a pelvic mass, prompting total hysterectomy. The latter harbored a 4.8-cm intramural uterine tumor corresponding to a mostly diffuse and focally nodular proliferation of medium to large cells, with extensive, periodic acid-Schiff negative, signet ring cell changes, and a pan-keratin negative, CD20+, CD10+, Bcl2+, Bcl6+ immunophenotype. Molecular genetic studies showed the same clonal IGH gene rearrangement in the lymph node and the uterus, establishing the uterine tumor as a relapse of the preceding follicular lymphoma, although no signet ring cells were evidenced at presentation. Uterine localization of lymphomas is rare, and lymphomas with signet ring cell features are uncommon. This exceptional case exemplifies a diagnostically challenging situation and expands the differential diagnosis of uterine neoplasms displaying signet ring cell morphology.
authors.affiliation: Institute of Pathology, Multidisciplinary Oncology Centre, Lausanne, Switzerland. rossella.sarro@chuv.ch
authors.forename: Rossella
authors.initials: R
authors.lastname: Sarro
authors.forename: Maryse
authors.initials: M
authors.lastname: Fiche
authors.forename: Bettina
authors.initials: B
authors.lastname: Bisig
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ketterer
authors.forename: Jean
authors.initials: J
authors.lastname: Benhattar
authors.forename: Chahin
authors.initials: C
authors.lastname: Achtari
authors.forename: Laurence
authors.initials: L
authors.lastname: de Leval
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone