RESUMO
It is very rare to have a lymphomatous involvement of ovary. Malignant lymphoma of ovary is a well-known late manifestation of disseminated nodal disease. Primary ovarian lymphoma with ovarian mass as an initial manifestation is a rare entity and may have varied presentations which can cause confusion to the physician and cause delay in diagnosis. Study presents a case of non-Hodgkin’s lymphoma where the initial presentation was fever with weight loss, and was evaluated as pyrexia of unknown origin. When no other cause of fever was identified PET-CT was done showing metabolically active uterine mass with no lymphadenopathy. Exploratory laparotomy was planned followed by hysterectomy with bilateral salpingo ophorectomy with omentectomy. Ovarian malignancy was detected intraoperatively, which was diagnosed as diffuse large B cell lymphoma, NHL double expresser phenotype on histopathology and IHC. Patient was started on chemotherapy and is doing fine.
RESUMO
Los linfomas ováricos son raros. Aquel que se presenta como una masa pélvica con manifestación inicial es aun más raro. El diagnóstico impreciso o tardío se debe a menudo a las lesiones que se presentan similares al cáncer de ovario y puede conducir a un desenlace desfavorable. Presentamos el caso de mujer de 48 años con dolor abdominal. La ecografía y tomografía computada preoperatoria mostraron tumor quístico heterogéneo. La laparotomía reveló tumoración anexial izquierda de origen ovárico. Se realizó histerectomía total, ooforo-salpingectomía bilateral y omentectomía parcial. No se encontró evidencia de que la lesión se hubiese propagado más allá del ovario. El diagnóstico de linfoma no Hodking del tipo difuso de células B grandes difusas del ovario se realizó mediante examen histopatológico junto con inmunohistoquímica del tejido extirpado. El paciente recibió seis ciclos de quimioterapia. Después de 18 meses de seguimiento, la paciente continúa libre de enfermedad.
Ovarian lymphomas are rare. Those presenting as a pelvic mass with initial manifestations are even rarer. Inaccurate or delayed diagnosis is often due to lesions resembling ovarian cancer and may lead to a poor outcome. We report the case of a 48-year-old female presenting with abdominal pain. Preoperative ultrasound and computed tomography showed a heterogeneous cystic mass. Laparotomy revealed a right adnexal mass of ovarian origin. Total hysterectomy, bilateral oophoro-salpingectomy, and partial omentectomy were performed. There was no evidence that the tumor had spread beyond the ovary. The diagnosis of primary nonHodgkin lymphoma of the ovary was done by histopathological examination along with immunohistochemistry of the excised tissue. The patient received six cycles of chemotherapy. After an 18-month follow-up, the patient continues free of disease.
RESUMO
Objective:To investigate the clinical features and prognostic factors of primary ovarian lymphoma(POL). Methods:A retrospective review was performed based on the clinical records of 14 POL cases treated at Tianjin Medical University Oncology in-stitute Hospital verity from 2000-6 to 2010-5. Results:The median age of patients was 47 years at presentation(range 28~62years). Ab-dominal pain was the most common initial symptom. The majority of histological subtype was B cell lymphoma, above 50%of which is diffuse large B-cell non-Hodgkin's lymphoma. A R0 resection was carried out in 2 patients who were lost to follow-up soon after sur-gery. 11 patients were treated by CHOP, FC or CHOPE chemotherapy. Chemotherapy combined with rituximab were given to 5 pa-tients. Until now, 5 patients were alive, 6 patients died, and only one patient was lost to follow up after therapy. Conclusion:POL is an extremely rare lymphoma. The ultimate diagnosis depends on histopathologic examination. Primary ovarian non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after oophorotomy is recommended. B cell lymphoma preferred to use rituximab combination chemotherapy. Abdominal cavity chemotherapy prophylaxis and irradiation can decrease the probability for recurrence .
RESUMO
Primary ovarian lymphoma is a rare malignancy whose symptoms or signs are usually nonspecific. In this article, we report a very rare case initially presenting as a rectal submucosal-tumor-like lesion with a defecation disturbance caused by primary ovarian lymphoma with bilateral involvement. A 42-year-old woman visited chungnam national university hospital complaining of persistent defecation disturbance for 6 months. Colonoscopy demonstrated compression of the rectum by an extrinsic mass mimicking a rectal submucosal tumor. Magnetic resonance imaging detected bilateral ovarian tumors, 9.3 cm and 5.4 cm each in diameter, compressing the rectum without enlarged lymph nodes. The diagnosis was established following a bilateral adnexectomy and histological studies of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient was prescribed six cycles of standard CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone) regimen and is presently on treatment.