Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Azadeh Memarian
Iran University of Medical Sciences, Iran
Scientific Tracks Abstracts: Gynecol Obstet
Clinical symptoms of female genital tract lymphoma are often non-specific and mimic other more common gynecological malignancies. Diagnosis can only be confirmed by histology. A 48 year-old multiparous woman was referred to the gynecology clinic because of enlarged myomatous uterus and persistent heavy vaginal bleeding. She underwent a subtotal hysterectomy and unilateral salpingo-oophorectomy in a hospital in Yazd (Iran). Intraoperatively severe bleeding occurred and dense cervical adhesions to peripheral tissues were found. Pathology report indicated benign leiomyoma. After a few months, an abdomino-pelvic CT scan was performed because of flank pain that revealed bilateral hydronephrosis. The patient was referred to the gynecology oncology clinic of Bahman Hospital in Tehran. Pelvic and rectovaginal exam and colposcopy were performed. Biopsy report was negative, after which mycobacterium tuberculosis test showed negative results. Under general anesthesia, multiple deep cervical biopsies revealed no malignancy again. The slides were reviewed by another â??referralâ? pathologist who reported atypical lymphoid infiltration, consistent with malignant lymphoproliferative disorder, in parametrial biopsies. Immunohistochemistry confirmed the diagnosis. The stony appearance of the cervix and a concomitant frozen pelvis strongly supported the diagnosis of cervical malignancy. The role of gynecological examination in the diagnosis of genital cancer is essential. When frozen pelvis and a fixed stony cervix are present, it is necessary to perform multiple deep biopsies in spite of previous negative pathologies. Review of the slides by qualified pathologists can help to achieve an accurate diagnosis. Despite histopathological errors, lymphoma should always be considered by pathologists, particularly in these unusual cases.
Azadeh Memarian has completed her expertise in Forensics from Iran University of Medical Sciences, Tehran, Iran. She is an Assistant Professor of Forensic Medicine. She has published more than 25 papers in journals and has been serving as an Editorial Board Member of Tehran University Medical Journal.
Email: azade.memarian@gmail.com