Primary Cervical Diffuse Large B-cell Lymphoma Incidentally Diagnosed During Evaluation of High-Grade Cervical Dysplasia: A Case Report

Primary diffuse large B-cell lymphoma (DLBCL) of the uterine cervix is a rare extranodal malignancy that may mimic more common cervical pathologies.We report the case of a 33-year-old woman with human papillomavirus (HPV)-16 positivity who was found to have cervical DLBCL incidentally during evaluation and treatment of high-grade squamous intraepithelial lesion (HSIL).Histopathologic analysis following repeat excisional procedure revealed DLBCL, germinal center B-cell subtype, without residual epithelial dysplasia.Staging positron emission tomography/computed tomography (PET/CT) demonstrated fluorodeoxyglucose (FDG) uptake confined to the cervix and central uterine cavity, without nodal or distant involvement.Bone marrow and endometrial biopsies were negative.The disease was classified as stage IE extranodal DLBCL with low-risk features.The patient was treated with four cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) using a PET-adapted approach based on the Intergroup S1001 trial and achieved a complete metabolic response.This case highlights an uncommon presentation of cervical lymphoma, the importance of accurate histopathologic diagnosis, and the role of PET-adapted therapy in limited-stage disease.