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Primary Endometrial Lymphomas: A Systematic Review.

Mahmoud Rezk Abdelwahed Hussein1, Manal Bahkali2, Toka Mahmoud R A Hussein3

  • 1Department of Pathology, Faculty of Medicine, Assiut University Hospitals, Assiut University, Assiut 71515, Egypt.

Diagnostics (Basel, Switzerland)
|March 28, 2026
PubMed
Summary
This summary is machine-generated.

Primary endometrial lymphomas (PELs) are rare uterine cancers. Marginal zone lymphoma and diffuse large B-cell lymphoma are the most common types, often presenting with abnormal uterine bleeding.

Keywords:
endometriumimmune cellslymphomapathologyprimary

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Area of Science:

  • Gynecologic Pathology
  • Hematopathology
  • Oncology

Background:

  • Primary endometrial lymphomas (PELs) are exceptionally rare and pose diagnostic challenges.
  • Understanding their clinicopathologic spectrum is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To systematically review and assess the clinicopathologic features of primary endometrial lymphomas (PELs).

Main Methods:

  • Systematic review adhering to PRISMA-2020 guidelines.
  • Comprehensive PubMed literature search (1956-2025) for English-language original articles on endometrial lymphoma.
  • Inclusion criteria focused on human studies, excluding reviews and non-English publications.

Main Results:

  • Analysis of 58 PEL cases from 42 studies, with abnormal uterine bleeding as the primary symptom.
  • Non-Hodgkin lymphoma predominated (57 cases), with Marginal Zone Lymphoma (MZL) and Diffuse Large B-cell Lymphoma (DLBCL) being the most frequent subtypes.
  • PELs were typically the sole lesion but occasionally coexisted with endometrial carcinoma; radiological imaging (US, CT, MRI, PET/CT) was vital for diagnosis and staging.

Conclusions:

  • MZL and DLBCL are the most common types of PELs, though other rare subtypes exist.
  • PELs can occur independently, within endometrial polyps, or in association with endometrial carcinoma.
  • Multimodal radiological assessment is essential for the diagnosis, staging, and follow-up of PELs.