Non-Hodgkin's B-cell lymphoma of the ovary

A report describes a case of a 30-year-old nulligravid woman who presented with abdominal fullness for about one month without any fever, chills, night sweats, or body weight loss. Her medical or family history was insignificant. 

Examination revealed a palpable lower abdominal mass. Lab investigations revealed elevated CA-125 levels along with lactate dehydrogenase. Pre-operative contrast material–enhanced CT demonstrated bilateral huge pelvic homogenous solid masses with partial central necrosis, a moderate amount of ascites, and several enlarged para-aortic and paracaval lymph nodes. 

Suspicion of ovarian malignancy prompted exploratory laparotomy, which revealed bilateral huge ovarian solid masses with smooth surfaces. The paraaortic lymph node enlargement was visible. Right salpingo-oophrectomy and subsequent histology suggested the presence of malignant lymphoma. Instead of a complete debulking surgery, the patient underwent a peritoneum biopsy, omental biopsy, washing cytology, and para-aortic lymph node sampling of the enlarged lymph nodes. The patient's recovery was uneventful.

She received the diagnosis of diffuse large B cell lymphoma. A whole-body positron emission tomography (PET) scan revealed intense 18-FDG uptake at the left adnexal mass lesion and multiple bone involvements. The diagnosis of diffuse large B-cell lymphoma was confirmed, and the patient received chemotherapy along with Ovarian suppression with a gonadotropin-releasing hormone (GnRH) agonist. She showed no evidence of recurrence in follow-up to 12 months after surgery.

Sung Y, Lin Y, Chen Y, Yeh L. Non-Hodgkin's B-cell lymphoma of the ovary: A case report and review of the literature. Taiwanese Journal of Obstetrics and Gynecology. 2022;61(3):539-543. https://doi.org/10.1016/j.tjog.2022.03.026