Vaginal Lymphoma with Immune Thrombocytopenic Purpura: An Unusual Case Report

• Main Authors: Akiko Ikuta, Yoshiaki Tanaka, Tomoko Tsuzuki, Shoko Tsuji, Genichiro Sumi, Tomomi Mizokami, Hisahide Sugimoto, Nobuaki Shikata, Katsuhiko Yasuda, Yorihiko Horikoshi, Hideharu Kanzaki
• Format: Article
• Language: English
• Published: Karger Publishers 2010-11-01
• Series: Case Reports in Oncology
• Subjects: Magnetic resonance imaging; Transvaginal ultrasonography; Vagina; Non-Hodgkin’s lymphoma; Immune thrombocytopenic purpura
• Online Access: http://www.karger.com/Article/FullText/289447

The female genital tract is rarely the initial site of presentation in lymphoma or leukemia. We report a case of non-Hodgkin’s lymphoma (NHL) presenting initially in the vagina. The patient, a 75-year-old woman, had a history of immune thrombocytopenic purpura (ITP). She presented with a chief complaint of genital bleeding and introital pain. On transvaginal ultrasonography, a vaginal tumor with an irregular wall was detected, and the internal echo showed a hypoechoic and echogenic pattern. Ultrasonography and magnetic resonance imaging (MRI) suggested that the vaginal tumor was likely to be a hematoma or a hemorrhagic tumor arising from ITP. Incision and resection for a hematoma or a hemorrhagic tumor were carried out in response to genital bleeding, introital pain, and pathological diagnosis. Postoperative microscopic examination confirmed that the tumor was a vaginal NHL. The final diagnosis using the Ann Arbor staging system was high-stage (stage IV) NHL. The patient received chemotherapy, and she remains in remission for 42 months after treatment.