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Babacan GB, Acar Tayyar MN, Şahin MC, Şengiz Erhan S, Tamam MÖ. Unusual Presence of Synchronous Primary Ovarian and Thyroid Extranodal Non-Hodgkin Lymphoma Without Lymph Node Involvement. Clin Nucl Med 2024; 49:e186-e187. [PMID: 38350088 DOI: 10.1097/rlu.0000000000005108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
ABSTRACT Extranodal lymphomas without lymph node involvement are rarely observed and create diagnostic challenges. We present the case of a 33-year-old woman who was admitted with abdominal swelling. Ultrasonography findings suggested bilateral ovarian masses. 18 F-FDG PET/CT revealed intense uptake on the bilateral pelvic mass and thyroid gland. Following excisional surgery and thyroid fine-needle aspiration biopsy, the patient was diagnosed with diffuse large B-cell lymphoma. This case is exceptionally rare, as it presents 2 synchronous extranodal involvements in the ovaries and the thyroid gland independently while not presenting any lymph node activity, which has not been reported before.
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Affiliation(s)
| | | | | | - Selma Şengiz Erhan
- Pathology, Prof. Dr. Cemil Taşcioğlu City Hospital, Hamidiye Faculty of Medicine, Health Science University, Istanbul, Turkey
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2
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Donatello D, Battista G, Sassi C. Imaging of ovarian lymphoma. J Ultrasound 2023; 26:799-807. [PMID: 37178392 PMCID: PMC10632316 DOI: 10.1007/s40477-023-00779-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/09/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE The aim of the study is to describe the radiological spectrum of appearances of ovarian lymphoma (OL). The manuscript describes the radiological aspects of OL to assist the radiologist in achieving correct orientation of the diagnosis. METHODS We conducted a retrospective evaluation of imaging studies of 98 cases of non-Hodgkin's lymphoma, with extra-nodal localisation (ovaries) in three cases (1 primary, 2 secondary). A literature review was also performed. RESULTS Of the three evaluated women, one had a primary ovarian involvement and two had a secondary ovarian involvement. The most common lesion characteristics were a well-defined, solid homogeneous and hypoechoic mass at US. CT depicts OL as a well-defined, non-infiltrating, homogeneous hypodense solid mass, with mild contrast enhancement. On T1-weight MRI, OL appears as a homogeneous mass of low signal intensity, which enhances avidly following intravenous gadolinium. CONCLUSION Clinical and serological presentation of OL can be similar to that of primary ovarian cancer. As imaging plays a central role in the diagnosis of OL, the radiologist should be familiar with US, CT and MRI appearances of this condition to correctly orient the diagnosis and so avoid unnecessary adnexectomy.
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Affiliation(s)
- Diana Donatello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, Via Massarenti, 9, Bologna, 40138, Italy.
| | - Giuseppe Battista
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, Via Massarenti, 9, Bologna, 40138, Italy
| | - Claudia Sassi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, Via Massarenti, 9, Bologna, 40138, Italy
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3
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Živković K, Marton I, Tikvica Luetić A, Gašparov S, Horvat Pavlov K, Sović L, Cerovac A, Habek D. Torquated large ovarian lymphoma as a cause of acute abdomen: a case report of diffuse large B-cell ovarian lymphoma with a germinal center B-cell-like phenotype. Wien Med Wochenschr 2021; 172:181-183. [PMID: 33616796 DOI: 10.1007/s10354-021-00823-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ovarian lymphoma is a rare neoplasm and most commonly represents secondary ovarian involvement in overt systemic disease, usually of the non-Hodgkin's type. AIM To report a case of acute abdomen caused by torquated large ovarian lymphoma. CASE REPORT We report the case of 65-year-old patient admitted to our hospital with signs and symptoms of acute abdomen. Findings were suggestive of left ovary torsion due to the neoplasm. After detorsion, mobilization, and adhesiolysis, a bilateral adnexectomy was performed. Histopathological and immunohistochemical analysis of the left ovarian tumor was performed and diagnosis of diffuse large B‑cell lymphoma (DLBCL) with a GCB (germinal center B‑cell-like) phenotype was made. Additional bone marrow biopsy and imaging techniques excluded other sites of involvement, confirming diagnosis of primary ovarian DLBCL. CONCLUSION The prognosis of ovarian lymphomas may be poorer than for other lymphomas because of late diagnosis. The best treatment option appears to be systemic chemotherapy.
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Affiliation(s)
- Krešimir Živković
- "Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Ingrid Marton
- "Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, University of Zagreb, School of Medicine, Zagreb, Croatia.,"Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, Catholic University of Croatia, Zagreb, Croatia
| | - Ana Tikvica Luetić
- "Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, University of Zagreb, School of Medicine, Zagreb, Croatia.,"Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, Catholic University of Croatia, Zagreb, Croatia
| | - Slavko Gašparov
- Merkur University Hospital, Department of Pathology and Cytology, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Katarina Horvat Pavlov
- Merkur University Hospital, Department of Pathology and Cytology, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Ljudevit Sović
- Department of Pediatric Surgery, Children's Hospital Zagreb, Zagreb, Croatia
| | - Anis Cerovac
- Department of Gynecology and Obstetrics, General Hospital Tešanj, Braće Pobrić 17, 74260, Tešanj, Bosnia and Herzegovina. .,Department of Anatomy, University of Tuzla, School of Medicine, Tuzla, Bosnia and Herzegovina.
| | - Dubravko Habek
- "Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, University of Zagreb, School of Medicine, Zagreb, Croatia.,"Sveti Duh" University Hospital, Department of Obstetrics and Gynecology, Catholic University of Croatia, Zagreb, Croatia
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Solitary Lip Extranodal Natural Killer/T-Cell Lymphoma on FDG PET/CT. Clin Nucl Med 2020; 45:410-411. [PMID: 32049729 DOI: 10.1097/rlu.0000000000002950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 54-year-old man presented with a history of upper lip pain for 4 weeks. Biopsy of the lip lesion revealed extranodal natural killer/T-cell lymphoma. F-FDG PET/CT scan showed the solely high uptake in the right upper lip without any other nodal or extranodal involvements.
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Karaosmanoglu AD, Uysal A, Onur MR, Hahn PF, Ayhan AS, Ozmen MN, Akata D, Karcaaltincaba M. Primary lymphomas of the intraabdominal solid organs and the gastrointestinal tract: spectrum of imaging findings with histopathological confirmation. Abdom Radiol (NY) 2019; 44:2988-3005. [PMID: 31209544 DOI: 10.1007/s00261-019-02100-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Unlike nodal lymphoma, primary lymphomas of the intraabdominal organs are uncommon neoplasms whose diagnosis may be challenging in certain clinical circumstances. Despite this difficulty for imaging diagnosis, there are several imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography that may suggest the correct diagnosis. The scope of this review is to describe and illustrate the imaging features of primary lymphoma of intraabdominal organs providing clues to the diagnosis, together with their pathological correlations.
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Singh S, Patra S, Bag ND, Naik M. Primary T-cell Lymphoblastic Lymphoma of the Ovary: A Case Report. Indian J Med Paediatr Oncol 2017; 38:81-83. [PMID: 28469345 PMCID: PMC5398115 DOI: 10.4103/0971-5851.203501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary ovarian lymphoma is extremely rare. We report a case of primary T-cell lymphoblastic lymphoma of the ovary in a 31-year-old multiparous woman, who presented with abdominal pain. Her menstrual cycles were regular. There was no generalized lymphadenopathy or fever. On per abdominal examination, there was a firm, tender, solid, mobile mass with well-defined borders, corresponding to 20 weeks gestation, whose lower pole was easily reached. Per vaginum examination revealed a large adnexal mass in the right and anterior fornix. Transabdominal ultrasonography showed bilateral solid ovarian tumor measuring 13.9 cm × 11.8 cm on the right side and 10.0 cm × 6.3 cm on the left side with significant vascularity. Tumor markers were within normal limit except for significantly elevated serum lactate dehydrogenase. Magnetic resonance imaging showed two large solid homogeneous masses, hypointense on T1W1 and hyperintense on T2W1 imaging, with a normal sized uterus and no ascites or lymphadenopathy. The patient developed one episode of left hemiparesis preoperatively, which improved spontaneously. Staging laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy along with infracolic omentectomy was done. Histopathology with immunohistochemistry revealed primary T-cell lymphoblastic lymphoma of the ovary, involving both ovaries left fallopian tube and left serosal surface of fundal region of uterus. She developed generalized convulsions on the 12th postoperative day, and final diagnosis was primary ovarian T-cell lymphoblastic lymphoma Ann Arbor Stage IV. She received three cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone regimen and was on palliative care. She succumbed to her illness 5½ months postoperatively.
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Affiliation(s)
- Sweta Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Susama Patra
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Narbadyswari Deep Bag
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Monalisha Naik
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Bhartiya R, Kumari N, Mallik M, Singh RVN. Primary Non-Hodgkin's Lymphoma of the Ovary - A Case Report. J Clin Diagn Res 2016; 10:ED10-1. [PMID: 27437236 DOI: 10.7860/jcdr/2016/19346.7766] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 04/05/2016] [Indexed: 11/24/2022]
Abstract
The ovarian lymphoma is rare. Lymphoma presenting as an ovarian mass with initial manifestation is even rarer. We report a case of primary Non-Hodgkin's Lymphoma (NHL) of left ovary in a 52-year-old female presented with distension of abdomen and lower abdominal back pain. USG and CT-scan imaging suggested provisional diagnosis of ovarian tumour. The diagnosis of malignant lymphoma was made by histopathological examination of the excised tissue along with immunohistochemistry by using LCA, CD20, cytokeratin & CD3. The tumour was classified as diffuse large B cell lymphoma. Rarity of this lesion warrants its mention.
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Affiliation(s)
- Richa Bhartiya
- Associate Professor, Department of Pathology, Patna Medical College & Hospital (PMCH) , Patna, India
| | - Nawanita Kumari
- Post Graduate Student, Department of Pathology, Patna Medical College & Hospital (PMCH) , Patna, India
| | - Mahasweta Mallik
- Assistant Professor, Department of Pathology, Patna Medical College & Hospital (PMCH) , Patna, India
| | - Ran Vijoy Narayan Singh
- Professor, Department of Pathology, Vardhaman Institute of Medical Sciences (VIMS) , Pawapuri, Nalanda, India
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Non-Hodgkin lymphoma dominated by multiple organ extranodal disease revealed on FDG PET/CT. Clin Nucl Med 2015; 40:360-3. [PMID: 25608171 DOI: 10.1097/rlu.0000000000000680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The definition of primary extranodal lymphoma is rather controversial and often complicated by the variety of lymphoma types. Here we describe FDG PET/CT findings in 3 pediatric patients with diffuse large B-cell non-Hodgkin lymphomas dominated by extranodal lesions involving multiple organs. Lymphomas arising primarily in extranodal sites can present significant diagnostic challenges due to their morphological diversity and lack of uniformity in histopathological classification.
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Diffuse Large B-Cell Lymphoma Infiltrating Limb Bones With a Few Lymphadenopathy Revealed on Whole-Body 18F-FDG PET/CT. Clin Nucl Med 2015; 40:569-71. [PMID: 25742230 DOI: 10.1097/rlu.0000000000000755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A 74-year-old man presented to our hospital for a 2-month history of worsening feet and left hand swelling pain. Computed tomography reconstruction image and sagittal images of the left foot demonstrated multiple and irregular bone destruction. Orthopedic surgeon suspected tuberculosis or primary skeletal malignancy. ¹⁸F-FDG PET/CT revealed bone destruction and abnormal activity mainly in bones of both upper and lower extremities and a few lymphadenopathy at the region of left axilla and groin. Diagnosis of diffuse large B-cell lymphoma was eventually made. Subsequently, the patient was transferred to the department of oncology and responded well to antilymphoma therapy.
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Basu S, Li G, Alavi A. PET and PET–CT imaging of gynecological malignancies: present role and future promise. Expert Rev Anticancer Ther 2014; 9:75-96. [DOI: 10.1586/14737140.9.1.75] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ghadyalpatil NS, Chandrasekar R, Snehalatha D, Reddy BM. A case of primary ovarian lymphoma with autoimmune hemolytic anemia achieving complete response with Rituximab-based combination chemotherapy. Indian J Med Paediatr Oncol 2012; 32:207-10. [PMID: 22563154 PMCID: PMC3343247 DOI: 10.4103/0971-5851.95142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- N S Ghadyalpatil
- Department of Medical Oncology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
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Lalwani N, Shanbhogue AK, Bhargava P, Vikram R, Prasad SR. Rare, Miscellaneous Primary Ovarian Neoplasms: Spectrum of Cross-Sectional Imaging. Curr Probl Diagn Radiol 2012; 41:73-80. [DOI: 10.1067/j.cpradiol.2011.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and (18)F-FDG PET/CT. Nucl Med Mol Imaging 2011; 45:223-8. [PMID: 24900009 DOI: 10.1007/s13139-011-0089-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 06/02/2011] [Accepted: 06/03/2011] [Indexed: 10/18/2022] Open
Abstract
A 20-year-old woman, who presented with a several-week history of abdominal pain, was referred for magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after an ultrasound showed complex cystic masses arising from both ovaries. The MRI and (18)F-FDG PET/CT imaging characteristics of the ovarian masses were strongly suspicious for malignancy, and the masses were surgically removed. Histopathological evaluation revealed a bilateral tubo-ovarian abscess, with no evidence of malignancy. This case highlights a potentially serious pitfall in the evaluation of suspicious pelvic masses by (18)F-FDG PET/CT, whereby a complex bilateral tubo-ovarian abscess may mimic the PET/CT imaging characteristics of an ovarian or pelvic malignancy.
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Cheng G, Servaes S, Chamroonrat W, Li J, Zhuang H. Non-Hodgkin's lymphoma of the bone and the liver without lymphadenopathy revealed on FDG-PET/CT. Clin Imaging 2011; 34:476-9. [PMID: 21092880 DOI: 10.1016/j.clinimag.2009.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 11/20/2009] [Indexed: 11/19/2022]
Abstract
Primary extranodal lymphomas are much less frequent than nodal lymphomas. Osseous and hepatic lymphomas commonly present with additional nodal lesions. Primary lymphoma of the bone or of the liver without nodal disease is uncommon. We describe a case of extranodal non-Hodgkin's lymphoma with numerous osseous and hepatic lesions without any lymph node involvement on FDG-PET/CT images. This is the first report of the coexistence of both osseous and hepatic lymphoma in the same patient without any lymph node involvement.
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Affiliation(s)
- Gang Cheng
- Department of Radiology, The Children's Hospital of Philadelphia, PA 19104, USA
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