Primary ovarian lymphoma in an infant: report of a case

Ovarian Non-Hodgkin Lymphoma Revealed by Bone Metastasis: A Rare Pediatric Case

Ovary involvement of non-Hodgkin lymphoma (NHL) is rare. We report a rare case of ovarian NHL during adolescence revealed by bone metastasis. The diagnosis of malignant lymphoma was established after adnexectomy and histological study of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient has been treated according to the LMB French protocol with good outcome after two years. Although NHL is a rare ovarian neoplasm, it is essential to establish an accurate diagnosis as early as possible for therapeutic purposes.

Ovarian Diffuse Large B-cell Lymphoma Initially Suspected Dysgerminoma Managed by Laparoscopic Staging Surgery

Ovarian diffuse large B-cell lymphoma (DLBCL) is rare. DLBCL is a complex type of lymphoma. The ovarian DLBCL usually harbor a favorable prognosis. We report a case of ovarian DLBCL that presented as an ovarian mass with lower abdominal pain and was managed using laparoscopic staging surgery. A 29-year-old female (gravida 2, para 0, abortion 2) with a history of polycystic ovarian syndrome with irregular medication control visited our clinic due to lower abdominal pain. Transvaginal ultrasound revealed a heterogeneous, septated mass over the left adnexa with a diameter of approximately 6 cm × 8 cm. The tumor marker CA 19-9 was elevated (65.77 IU/mL); CA125 and carcinoembryonic antigen were not elevated. Laparoscopic surgery with left salpingo-oophorectomy was first performed. Frozen section indicated dysgerminoma. Then, we continued staging surgery through bilateral pelvic lymph node dissection, para-aortic lymph node dissection, omentectomy, right ovary and peritoneum biopsy, and washing cytology. Ovarian tumor and para-aortic lymph nodes were positive for lymphoma. The tumor cells were positive staining for CD20, CD5, ki67, BCL-6, and MUM-1, which was associated with DLBCL. The patient was then consulted for oocyte preservation and referred to hematology for further chemotherapy. In conclusion, an ovarian lymphoma is a rare event. The presence of an enlarged ovarian tumor should raise the suspicion of ovarian lymphoma. To differentiate ovarian lymphoma from dysgerminoma, immunohistochemistry is useful. Fertility preservation should be considered before chemotherapy. Ovarian tissue or oocyte preservation or gonadotropin-releasing hormone agonist injection before chemotherapy can be performed for fertility preservation.

Bilateral ovarian B-lineage lymphoblastic lymphoma with MLL gene rearrangement: a novel case in infancy

Mixed-lineage leukemia (MLL) gene rearrangements have rarely been reported in pediatric lymphoma despite their high prevalence in pediatric leukemia. We present a case of an infant with bilateral ovarian B-lineage lymphoblastic lymphoma with MLL gene rearrangement. We also briefly summarize the clinicopathologic significance of MLL gene rearrangements, and review the reported cases of pediatric ovarian lymphoma with and without MLL rearrangement.

Characteristics and outcome of pediatric non-Hodgkin lymphoma patients with ovarian infiltration at presentation

BACKGROUND

Ovarian infiltration in pediatric non-Hodgkin lymphoma (NHL) at presentation is rare and information on outcome is scarce and mainly based on case reports and small series.

PROCEDURE

Evaluation of clinical characteristics and outcome of ovarian infiltrated pediatric NHL cases of a single center, and an extensive review of the all cases reported so far in literature.

RESULTS

At presentation, 6/60 female NHL cases of our center had ovarian infiltration, and combining these cases with earlier case reports, a total of 42 cases were identified. Median age at presentation was 10.9 years (range 0-18), and all but one had a B-cell immunophenotype, with 32/42 cases being classified as Burkitt. Bilateral involvement was reported in 26/41 cases, of which 22 were bilaterally ovariectomized as first treatment. All cases were treated with chemotherapy. Relapses were reported in 9/36 and death in 16/36. After follow-up in our center (median 13.4 years), in 2 cases anti-Müllerian hormone (AMH) values were available (2.1 and 0.9 µg/L), in non-ovarian cases median 2.2 µg/L.

CONCLUSIONS

We conclude that in case of ovarian tumors with negative markers, NHL should be considered in order to avoid unnecessary surgery.

Ovarian cysts and tumors in infancy and childhood

AIM

Review of the clinical presentation, types (histology), and stages of presentation and overall outcome of ovarian tumors.

MATERIALS AND METHODS

This is a retrospective study. Forty nine girls from 3 days to 12 years were included in the study.

RESULTS

Fourteen girls had benign and thirty three had malignant ovarian tumors. One girl had bilateral ovarian non-Hodgkin lymphoma. Dysgerminoma (40%) was the commonest malignant tumor followed by malignant teratoma (16.6%).

CONCLUSION

Pain and abdominal lump are the most common modes of presentation. Prognosis depends on the size of the tumor, stage and histology of the tumor. Conservative surgery should be the aim. Multidisciplinary management gives good prognosis.

Anaplastic large cell lymphoma of the ovary in a pediatric patient

Lymphoma can rarely present as an ovarian tumor in children. We describe the unusual case of a 14-year-old adolescent with a locally disseminated ovarian anaplastic large-cell lymphoma, treated with surgery followed by chemotherapy, and who remains disease free at 2 years after diagnosis.

Lymphoma of the female genital tract: current status

SUMMARY

: Primary lymphomas affecting the female reproductive system are uncommon but often pose a diagnostic challenge if their existence is not suspected. This article reviews the pathological and clinical features of lymphomas occurring in various sites in the female genital tract including the vulva, vagina, cervix, endometrium, fallopian tubes, and ovaries. Using the recent World Health Organization classification, the various types of lymphomas are identified as separate diseases and not as morphological variations of the same disease. The immunophenotypic and cytogenetics features of the major lymphomas are summarized. The incidence, presenting symptoms, gross and microscopic features, major differential diagnostic considerations, response to therapy, and expected outcome are discussed. Using published data on patient outcome, the International Federation of Obstetricians and Gynecologists and Ann Arbor staging systems are compared for their predictive value, and the difficulty in assigning primary and secondary status in extranodal lymphomas is emphasized. The observed differences in the behavior of some lymphomas in gynecological sites compared with their usual nodal location are presented. Finally, the possible etiology of these conditions is discussed in light of the emerging paradigm of mucosa-associated lymphoid tissue lymphomas.

A case of primary ovarian lymphoma in a child with high levels of CA125 and CA19-9

Primary ovarian lymphoma is extremely rare in children. The authors report a case of primary ovarian lymphoma in a child with high levels of CA125 and CA19-9. To their knowledge, this is the first such case to be reported in the literature.

Non-Hodgkin malignant lymphoma revealed by an ovarian tumor

BACKGROUND

The initial manifestation of a lymphoma as an ovarian mass is unusual, with a reportedly poor prognosis. An exploratory laparotomy is often performed as the ovarian tumor can mimic an advanced epithelial carcinoma. The criteria of lymphoma used in the selection of a nonsurgical approach, that is, chemotherapy possibly associated with radiation, are rarely defined.

CASE

We report the case of a 36-year-old woman who presented with an ovarian tumor suggestive of advanced carcinoma. After an initial approach including optimal surgery, the diagnosis of large B-cell CD30+ non-Hodgkin malignant lymphoma was established. Complete remission was obtained after a chemotherapy regimen, appropriate to the specific histologic type of the lymphoma.

CONCLUSION

The choice treatment of ovarian non-Hodgkin lymphoma (NHL) is chemotherapy. In the presence of an ovarian tumor, the possibility of ovarian NHL must be considered, and its clinical, biological, and/or radiological signs must be actively sought. Controlled biopsies must also be included to avoid mutilating surgery.

Precursor B-cell Lymphoblastic Lymphoma of the Ovaries: An Immunohistochemical Study and Review of the Literature

A 46-year-old woman presented with increasing abdominal girth. Investigations revealed bilateral ovarian tumors but no evidence of systemic disease. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. There was no evidence of extraovarian tumor at the time of the operation. A diagnosis of precursor B cell lymphoblastic lymphoma was established by histologic examination, immunohistochemical staining, and molecular analysis. After a 6-month follow-up, there was evidence of focal bony involvement that improved after chemotherapy. Although non-Hodgkin's lymphoma may involve the female genital tract, particularly the ovaries, primary ovarian lymphoma is rare and its definition controversial. To the best of our knowledge, this is only the third reported case of a primary lymphoblastic lymphoma of the ovary.