Primary endometrial B-Cell lymphoma: Rare etiol- ogy of abnormal uterine bleeding and potential nonsurgical therapy

Our patient, a 68-year-old Caucasian female, had a 4to-6-week history of postmenopausal vaginal bleeding requiring more than 2 pads per day. Pelvic ultrasound demonstrated uterine prominence (8.6 cm x 6.1 cm x 4.9 cm) with thickening of the endometrial complex (1.2 cm), as well as uterine fibroids (Fig. 1). An endometrial biopsy demonstrated diffuse large B-cell lymphoma, CD-20 positive (Fig. 2). FDG-18 PET/CT of the skull to mid-thigh, performed for staging, demonstrated moderate FDG uptake within the uterine endometrium with an SUV max of 4.0 (Fig. 3). No other FDG-avid foci were evident. Bonemarrow biopsy was morphologically and immunophenotypically negative for involvement by large B-cell lymphoma.