Primary Lymphoma of the Female Genital Tract: A Needle in a Haystack

Primary lymphoma of the female genital tract (PLFGT) is a rare entity with nonspecific symptoms. Its prognosis relies on accurate and quick diagnosis and therapy despite the lack of standardized management guidelines. This study aimed to explore the clinicopathologic and radiologic characteristics; and differential diagnoses of women with lymphoma of the female genital tract (FGT) treated at the same institution. A retrospective study was conducted on 22 cases diagnosed with lymphoma of their FGT during the study period from June 2016 and December 2023. Medical records and radiologic, pathologic, management, and survival data were collected. The mean age was 49.45 yr, and the mean follow-up duration was 48 mo. Only 15 cases were diagnosed with PLFGT, while the remaining 7 cases were secondary to the disease. The ovary was the predominant site (9 cases), and diffuse large B-cell lymphoma was the main histologic subtype (90.9%). Eleven (50%) patients underwent surgery. PLFGT demonstrated a more favorable outcome (60% achieved complete remission). Treatment strategies and Ann Arbor staging were significantly correlated with overall survival. To avoid misdiagnosis, it is essential to include lymphoma in the differential diagnosis of histologically difficult gynecologic neoplasms. Increasing awareness about this rare entity and providing a preoperative diagnosis is paramount to avoid unnecessary gynecologic surgery.