Primary Vaginal Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (NHL) is a type of blood cancer and 25% of NHL patients present with a primary extranodal tumor. Primary NHL of the vagina is extremely rare with only a few cases reported. We present the case of a 79-year-old, grand multipara, Peruvian woman with an eleven-month history of symptoms of pelvic and vaginal pain and vaginal bleeding. Vaginal examination revealed an exophytic tumor that involved the labia, right vaginal wall, cervix, parametrium, and pelvic bone. A computed tomography (CT) image showed a 10 x 10 x 9-cm solid tumor in the pelvic cavity with irregular edges in the pelvic floor, parametrium, and the perineal soft tissues. Bilateral pelvic and inguinal adenomegalies were found. No signs of metastases were found. Marrow and bone biopsy studies were negative. The diagnosis was NHL type diffuse large B-cell lymphoma (DLBCL) of vagina stage one. The patient was treated with six courses of CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab). She showed a complete response and remained in remission in follow-up control visits. NHL of the female genital tract is rare. CHOP-R is the first line of treatment for this type of cancer. However, less is known about the follow-up protocol and relapse management. Vaginal lymphoma has an extremely low prevalence, and collaborative studies are required to study the same.