Successful conservative treatment of primary endometrial marginal zone lymphoma (MALT type) : A case report and review of the literature

Abstract

Rationale: Primary endometrial marginal zone lymphoma (mucosa-associated lymphoid tissue [MALT] type) is a rare histological type of non-Hodgkin lymphoma (NHL); therefore, this disease is challenging to diagnosis and treatment. Patient concerns: A 61-year-old (gravidity 2, parity 2) female was admitted complaining of postmenopausal vaginal bleeding for 2 months. Diagnoses: An ultrasound revealed a slightly thickened endometrium. Histology revealed a dense lymphoid infiltrate in the endometrium, which was suggestive of an NHL. The atypical lymphocytes were positive for CD20 and BCL-2. Moreover, the PCR demonstrated monoclonal heavy chain gene rearrangement. Taken together, the diagnosis of primary endometrial marginal zone lymphoma (MALT type) was established. According to Ann Arbor criteria, the disease was staged IEA. Interventions: Dilatation and curettage was performed, and no additional surgery or radiotherapy and chemotherapy was administered. Outcomes: The patient was alive with no evidence of cancer for ≥41 months. Lessons: Primary endometrial marginal zone lymphoma (MALT Type) is a very rare indolent tumor, and its prognosis seems to be good. Thus, conservative treatment and no further therapy were suggested based on the tumor biology. Abbreviations: CT = computed tomography, D&C = dilatation and curettage, EMZL = extranodal marginal zone lymphoma, IHC = immunohistochemistry, MALT = mucosa-associated lymphoid tissue, NHL = non-Hodgkin lymphoma.