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.