A case report of primary ovarian diffuse large B-Cell lymphoma

Abstract

Primary ovarian non-Hodgkin’s lymphoma (NHL) is rare. B-cell and T-cell NHL can arise in the ovary but B-cell tumours are most common. 1 We present a case of a 76-year-old woman who presented with lower abdominal pain for one month and a complex 15cm left ovarian mass, for which she underwent a laparotomy and removal of the mass. She had no lymphadenopathy or masses on MRI. A frozen section was performed intra-operatively which showed a discohesive tumour, favouring lymphoma. Paraffin H&E sections showed a tumour composed of sheets of discohesive cells with angular, hyperchromatic nuclei and scant cytoplasm, frequent mitoses and necrosis. The tumour extended into adherent fat on the surface of the tumour. Immunohistochemical studies were positive for CD45 and CD20, and negative for CK (AE1/ AE3), CD30 and CD10. Ki-67 stained 90% of tumour cells. Flow cytometry was suggestive of large B-cell lymphoma. The overall features were of an ovarian diffuse large B-cell lymphoma. Although rare, primary ovarian lymphoma should be considered in the differential diagnosis of a pelvic mass.