CONCLUSION AND RESULTS
The patient was then admitted for further management. Her laboratory
findings showed an increased level of Lactate Dehydrogenase level of 219
U/L (reference range: 100-210) and the rest findings were within normal
limits. Peripheral blood smear was within normal limits. Multi-detector
Computed Tomography (MDCT) of the neck and chest revealed bilateral
sub-centimeter cervical lymph nodes and prominent mediastinal lymph
nodes in the paratracheal, pre-carinal, AP window, and pre-vascular; the
largest measuring 1.6x1.7 cm in the pre-carinal region. Bone marrow
aspiration and bone marrow biopsy revealed marrow showing no involvement
with atypical lymphoid cells.
Subsequently, an R-CVP chemotherapy cycle was initiated which included
Inj. Rituximab 500mg on Day 1, Inj. Vincristine sulphate 2 mg on Day 2,
Inj. Cyclophosphamide 1000mg on Day 2 and Tablet prednisolone 60mg for
Day 1-5.
Following the completion of 6 cycles of chemotherapy, PET CT of the
whole body with contrast was done after 2.5 months which revealed
ill-defined soft tissue thickening of the vulva/ lower vagina with
minimal f-18 fluorodeoxyglucose uptake (Deauville score 2), likely
treated disease.
The purpose of this case report is to highlight a highly uncommon and
exceptionally rare vulvar condition. Primary vulvar NHL is exceedingly
uncommon, which can make its diagnosis challenging if not considered.