Ghadyalpatil N S, Chandrasekar R, Snehalatha D, Reddy B M
Department of Medical Oncology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India.
Indian J Med Paediatr Oncol. 2011 Oct;32(4):207-10. doi: 10.4103/0971-5851.95142.
Ovarian involvement as primary or secondary lymphomatous process is extremely uncommon. In most cases, the diagnosis is usually not suspected initially and is confirmed only after detailed histopathological evaluation. We report a patient with primary ovarian diffuse large B-cell lymphoma (DLBCL) and associated auto-immune hemolytic anemia (AIHA) who achieved complete remission after treatment with Rituximab-cyclophosphamide-doxorubicin-vincristine and prednisolone (R-CHOP) chemotherapy. This patient was a 50 year old female, who presented with fever, abdominal pain, vomiting, weight loss and anemia. Computed tomography scan of the abdomen and pelvis revealed a large left ovarian mass with bilateral hydronephrosis. We performed exploratory laparotomy and partial resection of the mass was done due to the adhesions. Histopathology confirmed the diagnosis of DLBCL. After six R-CHOP chemotherapy cycles, patient achieved complete response with correction of anemia. To our knowledge, this may be the first case report till date of primary ovarian DLBCL with AIHA treated with R-CHOP chemotherapy who achieved complete remission in terms of primary disease as well as hemolytic anemia.
卵巢作为原发性或继发性淋巴瘤病变极为罕见。在大多数情况下，最初通常不会怀疑该诊断，只有在详细的组织病理学评估后才能确诊。我们报告一例原发性卵巢弥漫性大B细胞淋巴瘤（DLBCL）合并自身免疫性溶血性贫血（AIHA）的患者，该患者在接受利妥昔单抗-环磷酰胺-阿霉素-长春新碱和泼尼松龙（R-CHOP）化疗后实现了完全缓解。该患者为一名50岁女性，出现发热、腹痛、呕吐、体重减轻和贫血症状。腹部和盆腔计算机断层扫描显示左侧卵巢有一个大肿块，并伴有双侧肾积水。我们进行了剖腹探查术，由于粘连仅对肿块进行了部分切除。组织病理学确诊为DLBCL。经过六个周期的R-CHOP化疗后，患者实现了完全缓解，贫血得到纠正。据我们所知，这可能是迄今为止首例接受R-CHOP化疗治疗的原发性卵巢DLBCL合并AIHA且原发性疾病和溶血性贫血均实现完全缓解的病例报告。
