Inoue Takamitsu, Satoh Shigeru, Saito Mitsuru, Horikawa Yohei, Tsuchiya Norihiko, Habuchi Tomonori
Department of Urology, Akita University School of Medicine, Akita 010-8543, Japan.
J Med Case Rep. 2010 Jun 18;4:184. doi: 10.1186/1752-1947-4-184.
Because the normal ovary is assumed to be devoid of lymphoid tissue, it is unusual for it to be an initial manifestation of malignant lymphoma. This case is the first report, to our knowledge, of post-transplant lymphoproliferative disorder involving the ovary as an initial manifestation.
Twenty-nine weeks after a living renal transplantation, a 38-year-old Japanese female, whose ethnic origin was Asian, presented with abdominal pain and a chronic high fever. Computed tomography revealed a right ovarian tumor and liver metastases. The patient underwent oophrectomy based on the clinical diagnosis of liver metastasis from the primary ovarian tumor. The pathological diagnosis was Epstein-Barr Virus-associated post-transplant lymphoproliferative disorder. While ovarian malignant lymphoma has a poor prognosis, complete remission of liver involvement in this case was achieved only with a reduction of immunosuppressants.
Clinicians should remember that malignant lymphoma could initially involve the ovary, especially if the patient is immunosuppressed after transplantation therapy.
由于正常卵巢被认为不含淋巴组织，因此卵巢成为恶性淋巴瘤的首发表现并不常见。据我们所知，本病例是首例以卵巢受累为首发表现的移植后淋巴细胞增生性疾病的报道。
一名38岁的日本女性（亚洲裔）在活体肾移植29周后，出现腹痛和持续高热。计算机断层扫描显示右侧卵巢肿瘤及肝转移。基于原发性卵巢肿瘤肝转移的临床诊断，患者接受了卵巢切除术。病理诊断为与爱泼斯坦-巴尔病毒相关的移植后淋巴细胞增生性疾病。虽然卵巢恶性淋巴瘤预后较差，但在本病例中，仅通过减少免疫抑制剂的用量就实现了肝脏受累的完全缓解。
临床医生应牢记，恶性淋巴瘤可能最初累及卵巢，尤其是在移植治疗后患者免疫抑制的情况下。
