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Primary malignant lymphomas of the uterus are exceedingly rare. When they do occur, they involve cervix more frequently than the corpus. Median age at presentation is around 50 years. The usual presentation is with abnormal vaginal bleeding. Since lymphomas are rarely ulcerated, pap smears are usually negative.

Cervical lymphomas are diffuse bulky masses that produce circumferential enlargement of the cervix. In some cases, they produce a polypoid, fungating, exophytic mass. The cut surface is yellow-white and can be soft and fleshy or rubbery and firm. Extension into nearby structures such vagina, parametria, pelvic side wall, and even ureter (causing hydronephrosis) is common. The majority of uterine/cervical lymphomas are diffuse large B-cell type. The remainder of the cases are follicular lymphomas or Burkitt lymphomas.

The image shows a diffuse lymphoid infiltrate in the cervix displacing and distorting the endocervical glands. The final diagnosis was diffuse large B-cell lymphoma.

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