Primary ovarian malignant lymphoma presenting as ovarian carcinomatosis: a case report and literature review.

INTRODUCTION: Primary ovarian lymphoma may present with a clinical scenario consistent with advanced epithelial ovarian carcinoma. Although ovarian lymphoma is a rare entity, accounting for 0.5% of all non-Hodgkin's lymphoma and 1.5% of all ovarian neoplasms, it should be included in the differential diagnosis of an ovarian mass. CASE: We report a case of a 78-year-old woman who presented with an ovarian neoplasm suggestive of advanced ovarian carcinoma. During diagnostic laparoscopy, biopsies were obtained with frozen section analysis revealing malignant lymphoma. Further histopathologic analysis revealed a diffuse large B-cell lymphoma (DLBCL). The treatment plan was for six cycles of R-CHOP chemotherapy. A drammatic response was noted after only three cycles of R-CHOP. CONCLUSION: Primary ovarian lymphoma presenting as an ovarian tumor is exceedingly rare. Since the prognosis and treatment of lymphoma differs significantly from ovarian carcinoma, a representative tissue sample of the adnexal tumor should be obtained and sent for frozen section analysis to establish the diagnosis. Principal treatment for non-Hodgkin's lymphoma is chemotherapy without surgical cytoreductive efforts.

Chronic exposure to outdoor air pollution and lung function in adults.

BACKGROUND: The extent to which chronic exposure to outdoor air pollutants influences lung function in adults is unclear. The aim of this study was to measure the association between chronic exposure to outdoor air pollutants and adult lung function. METHODS: The relationship between measures of lung function (forced expiratory volume in 1 s (FEV(1)) and FEV(1) as a percentage of forced vital capacity (FVC)) and average exposure to particulate matter <10 microm in diameter, nitrogen dioxide, sulfur dioxide and ozone was examined in four representative cross-sectional surveys of the English population aged > or =16 in 1995, 1996, 1997 and 2001. Year-specific estimates were pooled using fixed effects meta-analysis. RESULTS: Greater exposure to particulate matter <10 microm in diameter, nitrogen dioxide and sulfur dioxide was associated with lower adult FEV(1). The size of the effect on population mean FEV(1) was about 3% for particulate matter <10 microm, and 0.7% for nitrogen dioxide and sulfur dioxide, for a 10 microg/m(3) increase in pollutant concentration. The effects were most marked in men, older adults and ex-smokers. FEV(1) was not associated with ozone concentration. No associations were found between the pollutants and FEV(1) as a percentage of FVC. CONCLUSIONS: Chronic exposure to outdoor air pollution is associated with modestly reduced FEV(1) in adults.

International correlations between indicators of prevalence, hospital admissions and mortality for asthma in children.

BACKGROUND: There are extensive data on the prevalence of childhood asthma world-wide but the relationships between asthma symptom prevalence, mortality and hospital admissions have not been investigated. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) used a standard questionnaire to measure the 12-month period prevalence of asthma symptoms by parental report in 6-7 year olds in 40 countries, and by self-report in 13-14 year olds in 60 countries. The initial survey was in the mid 1990s (Phase One) and this was repeated in the early 2000s (Phase Three). We correlated the prevalence values of any wheeze and severe wheeze with national data on mortality and hospital admissions for asthma in 5-14 year olds. RESULTS: All correlations with prevalence were positive. In 13-14 year olds, the correlations between severe wheeze in Phase One and contemporaneous mortality and hospital admission rates were r = 0.32 (P = 0.047) and r = 0.73 (P = 0.003), respectively. In 6-7 year olds in Phase One, the correlation with severe wheeze and mortality was r = 0.42 (P = 0.024). In 14 countries the correlation between admission and mortality rates in the 5-14 year age group was r = 0.53 (P = 0.054). CONCLUSIONS: There are consistently positive associations between asthma symptom prevalence, admissions and mortality. The prevalence of asthma symptoms in children obtained from local questionnaire studies may provide a guide to estimate the incidence of severe episodes of asthma in countries with incomplete data on hospital admissions or mortality, or vice versa.