Marshall University, Huntington, WV, USA.
J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231154641. doi: 10.1177/23247096231154641.
Primary ovarian non-Hodgkin lymphoma is a rare lymphoma that is often associated with diagnostic delays, initial misdiagnosis, and inappropriate management. We report a case of ovarian diffuse large B-cell lymphoma (DLBCL) in a young female who initially presented with generalized fatigue, lower abdominal discomfort, and 40 pounds of unintentional weight loss. She subsequently had a computed tomography of abdomen done that showed fatty liver, hepatomegaly, and a left heterogeneous ovarian mass measuring about 4 × 4.2 cm. Transvaginal ultrasound was also done that showed a heterogeneous solid left adnexal mass measuring 7.4 × 5.6 × 6.6 cm. She subsequently had a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Immunohistochemistry (IHC) showed the malignant cells expressing PAX5, CD20, and BCL2 with a Ki-67 proliferation index greater than 90%. The cells were negative for AE1/AE3, S100, CD30, and cyclin D1. Aggressive B-cell lymphoma fluorescence in situ hybridisation (FISH) panel was positive for rearrangement of BCL6 and MYC, with no evidence of BCL2 rearrangement, consistent with a double-hit high-grade B-cell lymphoma. Immunohistochemistry for BCL6 and MU M1 showed positive staining in the malignant cells. CD10 was negative. The staining profile was consistent with nongerminal center B-cell-like type of DLBCL. Ovarian lymphoma is a very rare entity; the presence of an enlarged ovarian tumor should raise the suspicion of ovarian lymphoma, and our case also emphasizes on the use of IHC markers in diagnosing the ovarian DLBCL.
原发性卵巢非霍奇金淋巴瘤是一种罕见的淋巴瘤，常伴有诊断延迟、初始误诊和不当治疗。我们报告了一例年轻女性卵巢弥漫性大 B 细胞淋巴瘤（DLBCL），最初表现为全身乏力、下腹部不适和 40 磅的非自愿体重减轻。随后，她进行了腹部计算机断层扫描，显示脂肪肝、肝肿大和左侧异质性卵巢肿块约 4×4.2cm。经阴道超声检查也显示左侧附件不均匀实性肿块，大小为 7.4×5.6×6.6cm。随后，她进行了全子宫切除术和双侧输卵管卵巢切除术。免疫组织化学（IHC）显示恶性细胞表达 PAX5、CD20 和 BCL2，Ki-67 增殖指数大于 90%。细胞对 AE1/AE3、S100、CD30 和 cyclin D1 呈阴性。侵袭性 B 细胞淋巴瘤荧光原位杂交（FISH）检测呈 BCL6 和 MYC 重排阳性，无 BCL2 重排证据，符合双打击高级别 B 细胞淋巴瘤。BCL6 和 MU M1 的免疫组化染色显示恶性细胞阳性染色。CD10 为阴性。染色模式与非生发中心 B 细胞样型 DLBCL 一致。卵巢淋巴瘤是一种非常罕见的实体瘤；卵巢肿瘤增大应提示卵巢淋巴瘤的可能，我们的病例还强调了使用 IHC 标志物诊断卵巢 DLBCL 的重要性。
