A Newly Described Variant of Follicle Center Lymphoma Involving the Female Genital Tract

By: Joshua Swore, PhD
Posted: Wednesday, March 22, 2023

Follicle center lymphoma of the lower female genital tract is a novel, localized, low-risk variant of primary cutaneous follicle center lymphoma and should be distinguished from other more aggressive B-cell lymphomas, according to an article in The American Journal of Surgical Pathology. “In our consultation practice service, we encountered cases of primary lymphoma involving the cervix and the vagina that were of follicle center derivation, and this led us to search for cases of follicular lymphoma involving the lower female genital tract in our archives,” said Elaine S. Jaffe, MD, of the National Cancer Institute, Bethesda, Maryland, and colleagues.

The authors identified 15 cases of follicle center lymphoma of the lower female genital tract. In all cases, the disease was reported to present locally, with no evidence of distal metastasis or bone marrow involvement. The researchers identified a follicular pattern in 12 of 15 cases. Furthermore, it is noted that large centrocytes were a prominent feature of the disease, which was a cause of concern for the referring pathologists. A total of 2 cases were positive for BCL2, with 10 cases testing negative for BCL2 rearrangement. Next-generation sequencing identified TNFRSF14 as the predominate mutated gene, which was found in 6 of 10 cases, and no cases possessed CREBBP or KMT2D mutations.

The authors followed disease progression, finding 10 of 12 patients achieved a durable complete remission. Median follow-up of the study was 7.8 years, and patients achieved a 5-year overall survival rate of 100%. Thus, the investigators noted the variant is characterized by localized disease and a low risk of dissemination. The authors emphasized that awareness and recognition of follicle center lymphoma of the lower female genital tract are important in separating the disease from more aggressive B-cell lymphomas, which require different therapeutic approaches.

Disclosure: The study authors reported no conflicts of interest.

The American Journal of Surgical Pathology

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