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CD5-positive DLBCL diagnosed in a 74-year-old woman via uterine drainage fluid analysisRare uterine lymphoma case highlights need for careful diagnosis in older women

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Key Takeaway
Recognize that nonspecific features of uterine lymphoma can mimic other malignancies, requiring careful immunohistochemical evaluation.

A single case involving a 74-year-old woman is presented alongside a literature review regarding the diagnosis of CD5-positive diffuse large B-cell lymphoma (DLBCL) of the uterus. The setting and specific intervention details were not reported in the source material. The primary outcome focused on establishing the diagnosis through cytopathological and histopathological evaluation of uterine drainage fluid.

Immunohistochemical analysis revealed the tumor cells were positive for CD20, CD79a, CD19, PAX5, CD5, Bcl-6, and MUM1. Conversely, the profile was negative for CD3, CD10, Bcl-2, CD30, and Cyclin D1. Epstein-Barr virus encoding region (EBER) status was negative, and the Ki-67 proliferation index was 90%. These findings confirmed the diagnosis of CD5-positive DLBCL, specifically the non-germinal center B-cell subtype.

Safety data, including adverse events or tolerability, were not reported as this was a diagnostic case report. Key limitations include the exceedingly rare nature of this condition and the presence of nonspecific clinical and radiological features that often mimic other uterine malignancies. The study underscores that increased awareness of these specific cytological features is essential to prevent diagnostic oversight in patients with uterine drainage fluid abnormalities.

This study examined a single case of a 74-year-old woman who was found to have a rare form of cancer in her uterus. The specific condition was called CD5-positive diffuse large B-cell lymphoma, which is a type of blood cancer that can occur in the uterus. The doctors used special tests on the cells to identify the disease and confirm the diagnosis.

The tests showed that the cells had specific markers, such as being positive for CD20 and CD5, which helped identify the exact type of lymphoma. The cells also showed a high rate of growth, with a Ki-67 index of 90 percent. These findings helped distinguish this rare cancer from other more common uterine cancers that look similar.

Because this report is based on only one patient, it cannot tell us how common this disease is or how to treat it. The clinical signs and imaging results were not specific, meaning they could easily be mistaken for other uterine problems. This makes it very important for doctors to be aware of these specific cell features to avoid missing the diagnosis.

Readers should take away that while this is a real case, it is too small to change medical practice. The main point is that doctors need to know about these rare features to ensure they do not overlook this cancer when examining drainage fluid from the uterus.

What this means for you:
One rare case shows doctors must check for specific cell markers to avoid missing this uncommon uterine cancer.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
ObjectiveCases of diffuse large B-cell lymphoma (DLBCL) of the uterus co-expressing CD5 are exceedingly rare and diagnostically challenging due to its nonspecific clinical and radiological features, which often mimic other uterine malignancies. This study retrospectively analyzes the cytopathological and histopathological characteristics of this entity in uterine cavity drainage fluid to facilitate its recognition.MethodsWe analyzed a case of uterine CD5-positive DLBCL by collecting clinical data, imaging findings, cytology from uterine drainage fluid, and histology from endometrial curettage. A review of the pertinent literature on uterine DLBCL was also performed.ResultsA 74-year-old woman presented with a two-week history of abdominal distension and anorexia. Abdominal CT demonstrated uterine enlargement with a large fluid collection and multiple enlarged abdominal lymph nodes. Cytology of the uterine drainage fluid revealed numerous atypical lymphoid cells with large, hyperchromatic nuclei, scant basophilic cytoplasm, and a high nuclear-to-cytoplasmic ratio. Histology of the curettage specimens showed a diffuse infiltrate of large lymphocytes with necrosis. The tumor cells exhibited round, oval, or irregular nuclei, coarse chromatin, and prominent nucleoli. Immunohistochemically, the cells were positive for CD20, CD79α, CD19, PAX5, CD5, Bcl-6, and MUM1, and negative for CD3, CD10, Bcl-2, CD30 and Cyclin D1. In situ hybridization for Epstein-Barr virus-encoded small RNA (EBER) was negative. The Ki-67 proliferation index was 90%. These findings supported a diagnosis of CD5-positive DLBCL, non-germinal center B-cell subtype.ConclusionUterus DLBCL expressing CD5 is an exceedingly rare malignancy. Its diagnosis necessitates a comprehensive approach integrating clinical presentation, imaging, cytomorphology, and immunohistochemistry. Increased awareness of the cytological features of lymphoma in uterine drainage fluid is essential to prevent diagnostic oversight.
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