Five Cases of Non-Hodgkin B-Cell Lymphoma of the Ovary

The involvement of the ovary in lymphomatous process is rare. Such an involvement may occur in 2 ways, primary or secondary. We report 5 cases of ovarian non-Hodgkin’s lymphoma, with 3 of which primarily arising in the ovaries. Ovarian lymphoma can mimic more frequently occurring tumors including advanced epithelial carcinoma and radical surgery may be performed instead of a biopsy. The immunophenotypic and clinicopathologic features exhibited in this small series are described to call attention to early diagnosis and treatment of ovarian lymphoma. All patients were diagnosed as having DLBCL after ovary biopsy. Different treatment modalities were used and prognosis of the patients was reported. 1. Introduction Involvement of the ovary by malignant lymphoma, particularly Non-Hodgkin’s lymphoma (NHL), is a well-known manifestation of disseminated lymphoma with a frequency of 7% to 26% [1]. However, presumably primary ovarian Non-Hodgkin’s lymphoma (PONHL) is rare and accounts for 0.5% of NHL and 1.5% of ovarian tumors [2]. Diffuse large B-cell type accounts for about 20% of PONHL [3]. All of the cases presented in this report were diffuse large B-cell lymphoma. Primary ovarian lymphoma (POL) may be misdiagnosed as epithelial ovarian malignancy. This report describes 5 cases of ovarian NHL, with 3 of which primarily arising in the ovaries. The immunophenotypic and clinicopathologic features exhibited in this small series are described to call attention to early diagnosis and treatment of ovarian lymphoma. 2. Case 1 A 65-year-old, vaginally grand multiparous woman presented to our clinic with symptoms of night sweats and fatigue for a year. She reported 21 kilogram weight loss over the past year. She had no significant medical or family history and she had used no medications. Physical examination revealed a large, palpable, nontender mass with restricted mobility in both lower quadrants up to the level of the umbilicus. A low platelet count was detected, a level of 114 × 103？μL (the reference level: 142 × 103？μL). Serum CA 125 and lactate dehydrogenase (LDH) were raised (541？U/mL and 821？IU/L, resp.), but CA 19-9 and CEA were within normal limits. Transabdominal ultrasonography demonstrated a complex adnexal mass, measuring 12.5 × 11？cm with solid areas and internal echoes. A computer tomography (CT) scan revealed an 11 × 9 × 7？cm, solid, left ovarian mass with ascites (Figure 1). The patient underwent surgery with the presumed diagnosis of an ovarian malignancy. At laparotomy, about 2 liters of gelatinous floating material was scooped out of the