International Journal of Hematology and Blood Disorders

Long named as lymphoma in 1873 is the malignant tumor of the lymphocyte. Its occurrence in the vagina is a rarity. Since, single case reports have appeared in several countries, such a case found among the Igbo Ethnic Group in Nigeria deserves documentation. It was typical in causing vaginal bleeding and forming usually in its posterior wall worldwide. Unlike in some cases in which the lesion was extensive, our patient exhibited a localized mass whose excision led to uneventful recovery.

Keywords: Lymphocyte; Tumor; Lymphoma; Vagina; Bleeding; Posterior wall; Igbo’s;

The Merriam-Webster’s Collegiate Dictionary defines lymphoma as the malignant form of lymphatic tissue and dates 1873 as when it was first named [1]. Now, there are single case reports from Turkey [2], India [3], Italy [4], Portugal [5], China [6], Japan [7, 8], Spain [9], Germany [10], and Bulgaria [11]. Therefore, having encountered the single case, which appeared among the Igbo ethnic group [12], this report is deemed to be worthy of documentation. The lesions appeared as in other parts of the world, especially as regards bleeding from the posterior wall.

OE, a 37-year-old female consulted Dr B. Igbogbahaka at the Ucheoma Hospital at Aba, Nigeria, with the complaint of postcoital bleeding since 9 months. On inspection, a friable whitish mass was found to be attached to the posterior wall of the vagina. It was easily removed digitally. Complete excision was then undertaken.

A 4.5 x 3.0 x 2.0 cm mass was submitted to the senior author (WIBO). On section, it was surprisingly soft. On microscopy, there were sheets of round hyperchromate cells growing diffusely and manifesting the mitotic activity of lymphoma. Recovery was uneventful.

Many years ago, the senior author published the biography of Thomas Hodgkin [13], whose eponym adorns one type of the lymphomas. Hodgkin himself had written in terms of death with a medico-legal case in 1812 [14]. Recently, interest has been shown in this community with reference to several aspects of this malignancy [15-18].

As regards this malignancy, comparison of the local case of vaginal lymphoma with foreign cases may be appreciated. Thus, the local 37 years compared favorably with the 30 years in Turkey [2] as well as the 35 years in India [3] together with 44 years in Japan [8]. As for the precise origin, the posterior wall was the commonest site.

Treatment was supported in Turkey thus: “Primary involvement of the vagina can be successfully treated by pelvic irradiation but in young women chemotherapy should be considered to preserve fertility, as well as quality of life” [2]. Like the Indian patient, “There was no lymphadenopaty or hepatosplenogaly and the other systemic examination was normal” [3]. Unlike the Spanish woman, whose mass was “occupying the entire vaginal cavity” [9], our patient’s lesion was localized, this leading to her recovery being uneventful. Apparently, it was still a localized disease.

Elsewhere, as in France, “surgical treatment has to be limited, associated with polychemotberapy and completed by local radiotherapy” [19]. In USA, the picture included clinical follow up [20]. However, the present paper does not concern treatment, seeing that the lesions were submitted principally for histological diagnosis.

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