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Int J Clin Exp Pathol 2013;6(7):1422-1426

Case Report
Uterine leiomyoma with indolent B-lymphoblastic proliferation

Zhaoming Wang, Ke Sun, Wenbo Xiao

Department of Pathology, Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang
Province, PR China

Received April 16, 2013; Accepted May 25, 2013; Epub June 15, 2013; Published July 1, 2013

Abstract: Uterine leiomyoma with TdT positive B lymphocytes infiltrating is very rare and may simulate precursor B-cell lymphoblastic
lymphoma (B-LBL). To the best of our knowledge, this is the first description of such a lesion in English literature. A 51-year-old Chinese
woman was noted a mass in her uterus in a routine physical examination. The myomectomy specimen was identified as a well-defined 8.0x6.8
cm tumor and the cut surface was fresh and yellow-tan. A massive small lymphocytic infiltration accompanied by plasma cells and histiocytes
was noted in the leiomyoma but not in the surrounding non-neoplastic myometrial fibers. These cells were small in size without significant
nuclear irregularities and mitotic figures can not been seen. Immunohistochemical analysis has shown some small lymphocytes were CD20+,
CD79a+, Pax5+B cells and some were CD2+, CD3+, CD5+, CD43+T cells. The small B cells coexpressed TdT and Ki67 and were in patchy
dense distribution. The postoperative course was uneventful within a 30-month follow-up period without chemotherapy and radiotherapy. The
true nature of these TdT+ B cells has not been determined. (IJCEP1304026).

Keywords: Leiomyoma, lymphoblastic lymphoma, terminal deoxynucleotidyl transferase (TdT)

Address correspondence to: Dr. Wenbo Xiao, Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University,
No.79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China. Tel: +86-571-87236364; Fax: +86-571-87236570; E-mail:
xiaowb.111@163.com