Case 210: Primary Ovarian Lymphoma

Abstract

Abdominopelvic CT scans showed solid masses involving both ovaries (Fig 1a). Both ovaries were abnormally enlarged; the right ovary measured 16 3 10 3 11 cm, and the left ovary measured 6.2 3 3.7 3 5.3 cm. Both ovaries contained low-attenuation cysts displaced toward the periphery by an infiltrating soft-tissue tumor (Fig 1b, 1c). The infiltrating mass encased the right gonadal vessels (Fig 1d) from the hilum of the ovary (Fig 2) to the retroperitoneum; however, the vessels were not occluded. These findings were confirmed with subsequent surgery and histologic analysis (Fig 3). A few ascites in the peritoneal cavity were noted; however, there was no evidence of splenomegaly. No other mass lesion was detected in the abdomen or pelvis.A provisional diagnosis of ovarian tumor was made, and the patient underwent total abdominal hysterectomy, bilateral salpingooophorectomy, omentectomy, paraaortic lymph node dissection, and lavage for cytology. The diagnosis at pathology was primary ovarian lymphoma, diffuse large B-cell type. Bone marrow biopsy findings were negative. Chest CT findings also were negative. The patient underwent chemotherapy, and no tumor recurrence was noted during 1 year of follow-up.

Primary Ovarian Lymphoma: A Rare Entity

“…2 In almost all cases, non-Hodgkin lymphoma (NHL) with diffuse B-cell type is the commonest type, followed by Burkitt's lymphoma. Chein JC et al 3 in their study on primary ovarian lymphoma reported CA-125 level of 1366 U/ml 3 & mean level of 1111U /ml 3 but in our case, it is in lower side 839 U/ml 3 . This is a rare case with non-specific findings, hence Radiologists should be aware of this diagnosis.…”