Lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia initially presenting as postmenopausal pelvic pain and bleeding: a rare case report with literature review

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2026-04-01 Epub Date: 2026-03-28 DOI:10.1016/j.gore.2026.102075

Mackenzie Dent , Mustafa Al-Kawaaz , Kadam Maruthi , Jenci Hawthorne , Whitney Goldsberry , Catherine Spencer , Samer Z. Al-Quran

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引用次数: 0

Abstract

Background

Lymphoplasmacytic lymphoma / Waldenström macroglobulinemia (LPL/WM) is a rare and indolent low-grade B-cell lymphoproliferative neoplasm that often presents with vague symptoms or asymptomatically. While it most commonly involves the bone marrow, LPL/WM can sometimes involve the lymph nodes and spleen, and rarely the central nervous system, skin, and pleural cavities. We report a rare case of lymphoplasmacytic lymphoma/ Waldenström macroglobulinaemia presenting with predominant myometrial and cervical involvement.

Case presentation

A 57-year-old G2P2 postmenopausal female with a history of HPV + HSIL presented following a single episode of abnormal uterine bleeding with associated urinary urgency and pelvic pressure. Transvaginal ultrasound examination was unremarkable and endometrial biopsy via hysteroscopy was unsuccessful due to stenotic cervical os. The patient subsequently underwent a total robotic hysterectomy with bilateral salpingo-oophorectomy. Examination of histologic sections showed atypical perivascular lymphoid aggregates consistent with involvement by a low-grade B-cell lymphoma with predominant myometrial and cervical involvement. Differential diagnosis at the time included marginal zone lymphoma (MZL) and lymphoplasmacytic lymphoma (LPL). Additional testing identified an IgM kappa paraproteinemia with MYD88 p.L265P mutation. Bone marrow biopsy and aspirate confirmed the diagnosis of lymphoplasmacytic lymphoma / Waldenström macroglobulinaemia (LPL/WM).

Conclusion

To our knowledge, there have been only two cases previously described in the literature of LPL/WM involvement in the female genital tract; both of which had prominent involvement of the ovaries. Although exceedingly rare, LPL/WM involvement of the female genital tract should be considered on the differential diagnosis if atypical lymphoid cells or dense lymphoid aggregates are observed.

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淋巴浆细胞性淋巴瘤/Waldenström巨球蛋白血症最初表现为绝经后盆腔疼痛和出血：一例罕见病例报告并文献复习

背景淋巴浆细胞性淋巴瘤/ Waldenström巨球蛋白血症（LPL/WM）是一种罕见的、惰性的低级别b淋巴细胞增生性肿瘤，通常表现为症状模糊或无症状。虽然它最常累及骨髓，但LPL/WM有时可累及淋巴结和脾脏，很少累及中枢神经系统、皮肤和胸膜腔。我们报告一例罕见的淋巴浆细胞性淋巴瘤/ Waldenström巨球蛋白血症，主要表现为子宫肌和宫颈受累。病例介绍：一名57岁G2P2绝经后女性，HPV + HSIL病史，单次异常子宫出血伴尿急和盆腔压。经阴道超声检查无明显异常，宫腔镜子宫内膜活检因宫颈狭窄未能成功。患者随后接受了全机器人子宫切除术和双侧输卵管卵巢切除术。组织学切片检查显示非典型的血管周围淋巴细胞聚集，与低级别b细胞淋巴瘤的累及一致，主要累及子宫肌层和宫颈。当时的鉴别诊断包括边缘带淋巴瘤（MZL）和淋巴浆细胞性淋巴瘤（LPL）。进一步检测发现IgM kappa副蛋白血症伴有MYD88 p.L265P突变。骨髓活检和穿刺证实诊断为淋巴浆细胞性淋巴瘤/ Waldenström巨球蛋白血症（LPL/WM）。结论据我们所知，文献中仅有2例LPL/WM累及女性生殖道；这两例都明显累及卵巢。虽然非常罕见，但如果观察到非典型淋巴样细胞或密集淋巴样聚集物，则应考虑LPL/WM累及女性生殖道。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.