28 yrs Lady have had complaints due to vaginal compression from 2004.  
2004-2009 multiple vaginal biopsies were taken ("cervicitis", "fibroma", "without tumor").  
2009: bilateral stents in ureters, disuria, painfull intercourse, bilateral hydronephrosis.  
MRI: tumoral masses spreading to cervix, vagina, bladder, uterus, maybe to rectum.  
After "blind" (?) administration of steroids urine-blocking symtoms are relieved.  
Any B or systemic signs of the lymphoma (LDH, etc.). Perfect general condition.  
 
HISTO/CONSULTATION CASE 2009/all biopsies 2004-2009 with the same changes: Focal infiltrates with "dermatofibroma like" or "muaring" intersticial fibrosis/sclerosis, consists of large- medium sized cells with apoptosis, irregular nuclei. Visualisation is not optimal due to sclerosis and artefacts.  
IH: CD20+; Bcl6+; Bcl2/CD10/Mum1(-); Ki67 ~50%.  
 
VIRTUAL SLIDES (APPERIO) attached (selected most informative biopsies 2008-2009). In a case of emergency routine jpg's will be placed in seconds.  
PROPOSAL: DLBCL, GCB type with prominent fibrosis/sclerosis.  
CLONALITY: pending.  
FOLLOW UP: R-CHOP/ DLBCL therapy is planning after full evaluation.  
 
SPECIAL QUESTS/COMMENTS: 1. Indolent course (gyn extranodal lymphoma?) due to sclerosis, imitating retroperitoneal fibrosis? 2. Differential with FL (age, no follicles, no FDC networks, etc?). 3. Scarse case reports and reviews on the topic of "sclerosing" or "retroperitoneal/GYN" sclerosing lymphomas.