Ovarian Lymphoma Research Articles

Liver scalloping – An unusual presentation of a benign disease

Introduction: Abdominal tuberculosis frequently mimics other conditions such as inflammatory bowel disease, sarcoidosis, advanced ovarian tumour, lymphoma, mesothelioma or carcinomatosis. Case Report: The authors report the case of a 19-year-old woman with fever, abdominal pain and history of right pleural empyema. Laboratory findings showed anaemia, lymphopenia and positive interferon-gamma release assay. Computed tomography findings included apical lung nodules, pleural thickening, right pleural effusion and ascites. Treatment for suspected tuberculosis was started. Two months later, computed tomography showed peritoneal thickening causing liver scalloping. Fluid collection from a peritoneal fluid-filled nodule confirmed the diagnosis. Conclusion: Visceral scalloping is a common finding of carcinomatosis and pseudomyxoma peritonei; only seven cases are reported in peritoneal tuberculosis. We emphasize the need for a high suspicion level and early sample collection.

Clinical Response and Tolerability of Selinexor in Acute Myeloid Leukemia and Other Hematologic Malignancies - a Systematic Review

IntroductionSelinexor, a SINE (selective inhibitor of nuclear export) compound, inhibits exportin 1 (XPO1) involved in transport of tumor suppressor proteins leading to apoptosis of tumor cells. XPO1 is overexpressed in variety of cancer including ovarian cancer, pancreatic cancer, glioma, osteosarcoma, leukemia, lymphoma, and multiple myeloma. The aim of this study is to summarize clinical response and adverse events of selinexor in hematological neoplasms.MethodsA comprehensive literature search on PubMed, Embase, AdisInsight and Clinicaltrials.gov was completed on July 12, 2018. Studies focusing on efficacy and/or adverse events of selinexor in patients with hematological neoplasms were included for the review.ResultsOut of 321 studies found on initial search, we finalized 15 studies (8 phase I and 7 phase I/II) after screening by two reviewers. AMLSelinexor in combination with high-dose cytarabine and mitoxantrone has shown overall response rate (ORR) of 70% among 20 patients with acute myeloid leukemia (AML), Wang et al., 2018. Out of 12 newly diagnosed AML (ND AML) patients, 11 (92%) patients showed response with complete response (CR) in 7, CR with incomplete recovery (CRi) in 3 and partial response (PR) in 1 patient. Among 8 relapsed/refractory AML (R/R AML) patients, only 3 patients showed CR while 5 had treatment failure (TF), ORR in this subset was 38%. In 81 evaluable R/R AML patients receiving selinexor as monotherapy only 14% of the patients showed response while 31% patients had disease progression (PD) along with grade ≥3 hematological adverse events (AEs) of thrombocytopenia, anemia and neutropenia in 19%, 15% and 13% patients, respectively (Garzon et al., 2017). MMRelapsed refractory multiple myeloma patients receiving selinexor combined with pomalidomide and dexamethasone have achieved ORR of 60% with CR in 1 and PR in 5 patients (Chen et al., 2016 n=10) with grade ≥3 neutropenia in 8 patients. In another regimen with doxorubicin and dexamethasone the clinical benefit rate (CBR) was 26% with 15% overall response (Rachid et al., 2017 n=27). Grade ≥3 neutropenia, thrombocytopenia and hyponatremia occurred in 33%, 33% and 30% of patients, respectively. NHLKuruvilla et al. observed ORR in 31% patients with relapsed refractory non-Hodgkin lymphoma with single-agent selinexor. Grade ≥3 thrombocytopenia, neutropenia and anemia occurred in 47%, 32% and 27% patients, respectively. The efficacy of selinexor in phase I and I/II clinical trials is given in table 1 while toxicity is mentioned in table 2. With selinexor, the most common hematological and nonhematological AEs noted were thrombocytopenia and hyponatremia, respectively. ConclusionSelinexor based combination regimens have shown better clinical response against AML as compared to monotherapy. The efficacy results in multiple myeloma and other hematological malignancies are also encouraging. The adverse events like cytopenias were common as in other chemotherapy regimens. DisclosuresNo relevant conflicts of interest to declare.

An atypical presentation of an ovarian lymphoma: a case report

BackgroundOvarian lymphoma has a varied clinical presentation and rarely presents with heavy menstrual bleeding. It may occur de novo or secondary to systemic disease and macroscopically appear as solid ovarian tumors.Case presentationA 32-year-old Tamil woman presented with heavy menstrual bleeding of 4 months’ duration. On examination she was anemic with no lymphadenopathy. A large immobile pelvic mass and three firm nodules were found involving her vaginal walls. Ultrasonography suggested a fibroid uterus with two large pedunculated fibroids. Following preoperative optimization an endometrial sampling and biopsy of the nodules were done. Subsequently, histology revealed proliferative phase endometrium. The vaginal nodules showed lymphoid tissue.She presented a week later with an undulating fever and features of acute abdomen with clinical evidence of ascites. During an emergency laparotomy two large solid ovarian masses, gross ascites, pelvic lymph nodes, para-aortic lymph nodes, mesenteric lymph nodes, omental deposits, and a 24-week-size uterus were found. Bilateral oophorectomy was done. Laboratory investigations revealed raised lactate dehydrogenase with normal serum β-human chorionic gonadotropin, alpha-fetoprotein, and cancer antigen-125 levels. Histology of ovarian specimens revealed a diffuse large B cell lymphoma.A bone marrow biopsy revealed more than 80% infiltration with lymphoid cells. Two weeks after the laparotomy a computed tomography of her chest, abdomen, and pelvis revealed a pelvic mass, gross ascites, omental deposits, hepatosplenomegaly, and enlarged lymph nodes above and below her diaphragm. Immunohistochemistry confirmed the diagnosis of B cell lymphoblastic lymphoma. She was classified as stage IV E non-Hodgkin’s lymphoma on the Ann Arbor staging system.ConclusionThis is an atypical presentation of an ovarian lymphoma. The atypical presentations of ovarian lymphomas can lead to diagnostic dilemmas.

Use of myelosuppressive chemotherapy and colony-stimulating factor (CSF) prophylaxis: A longitudinal assessment of practices participating in the Centers for Medicare and Medicaid Services (CMS) oncology care model (OCM).

12 Background: The CMS OCM is a 5-year program (7/2016 – 6/2021) focused on improving oncology care by incentivizing practices via financial and performance accountability. Little is known about practices participating in the OCM and whether patterns of care have changed over time. Methods: We used a retrospective cohort with structured elements from national electronic health record dataset provided by Flatiron Health (1/2012-12/2017). Data were de-identified to prevent patient and provider re-identification. Study population included adults with breast, colorectal, lung, or ovarian cancer or non-Hodgkin lymphoma who received chemotherapy with intermediate/high-risk for febrile neutropenia (FN). Patient characteristics, treatment, and supportive care within OCM and non-OCM practices were evaluated overall and by calendar year. Results: Study population included 42,699 patients at 53 OCM practices, and 25,613 patients at 149 non-OCM practices. OCM practices were larger (mean: 806 vs. 172 patients); age (mean: 62 vs. 62 years), cancer type (breast cancer: 53% vs. 52%), chemotherapy (high FN-risk: 49% vs. 48%), and other characteristics were comparable between patients in OCM and non-OCM practices. Use of high (vs. intermediate) FN-risk chemotherapy in 2012, 2015, and 2017 was 48%, 50%, and 48% in OCM practices and 50%, 50%, and 48% in non-OCM practices. CSF prophylaxis use, while higher in OCM practices, decreased over time in both subgroups (OCM: 70% in 2012 to 65% in 2017; non-OCM: 63% in 2012 to 58% in 2017). Use of pegfilgrastim (vs. short-acting CSFs) was > 94% across years in OCM and non-OCM practices. Use of the on-body injector (vs. prefilled syringe) increased from 26% of pegfilgrastim use in 2015 to 73% in 2017 in OCM practices and from 16% to 63% in non-OCM practices. Conclusions: Although OCM practices are larger and more commonly use CSF prophylaxis than non-OCM practices, trends in use of high FN-risk chemotherapy and declining prophylactic support appear to be similar between subgroups. Additional research is needed to evaluate whether such changes impacted health outcomes.

Burkitt lymphoma of the ovaries mimicking sepsis: a case report and review of the literature

BackgroundIt is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility.Case presentationWe present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock – multiple organ failure as a result of a suspected gynecological infection of the ovaries. An immediate improvement of her clinical condition in combination with strong clinical suspicion and negative cultures led to the differential diagnosis of diseases other than sepsis. Based on the results of the biopsies that were obtained by research laparotomy, our patient suffered from primary Burkitt ovarian lymphoma. Her clinical condition improved with supportive treatment and chemotherapy. Chemotherapy is the dominant treatment for Burkitt’s lymphoma, while surgery or radiotherapy has no place.ConclusionsAll intensivists should be aware of clinical conditions that mimic sepsis as early diagnosis can lead to appropriate therapy and avoid unnecessary diagnostic tests and antibiotic abuse.

AUCTSP: an improved biomarker gene pair class predictor

BackgroundThe Top Scoring Pair (TSP) classifier, based on the concept of relative ranking reversals in the expressions of pairs of genes, has been proposed as a simple, accurate, and easily interpretable decision rule for classification and class prediction of gene expression profiles. The idea that differences in gene expression ranking are associated with presence or absence of disease is compelling and has strong biological plausibility. Nevertheless, the TSP formulation ignores significant available information which can improve classification accuracy and is vulnerable to selecting genes which do not have differential expression in the two conditions (“pivot" genes).ResultsWe introduce the AUCTSP classifier as an alternative rank-based estimator of the magnitude of the ranking reversals involved in the original TSP. The proposed estimator is based on the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) and as such, takes into account the separation of the entire distribution of gene expression levels in gene pairs under the conditions considered, as opposed to comparing gene rankings within individual subjects as in the original TSP formulation. Through extensive simulations and case studies involving classification in ovarian, leukemia, colon, breast and prostate cancers and diffuse large b-cell lymphoma, we show the superiority of the proposed approach in terms of improving classification accuracy, avoiding overfitting and being less prone to selecting non-informative (pivot) genes.ConclusionsThe proposed AUCTSP is a simple yet reliable and robust rank-based classifier for gene expression classification. While the AUCTSP works by the same principle as TSP, its ability to determine the top scoring gene pair based on the relative rankings of two marker genes across all subjects as opposed to each individual subject results in significant performance gains in classification accuracy. In addition, the proposed method tends to avoid selection of non-informative (pivot) genes as members of the top-scoring pair.

Linfoma no Hodgkin primario de ovario. Reporte de caso

Los linfomas ováricos son raros. Aquel que se presenta como una masa pélvica con manifestación inicial es aun más raro. El diagnóstico impreciso o tardío se debe a menudo a las lesiones que se presentan similares al cáncer de ovario y puede conducir a un desenlace desfavorable. Presentamos el caso de mujer de 48 años con dolor abdominal. La ecografía y tomografía computada preoperatoria mostraron tumor quístico heterogéneo. La laparotomía reveló tumoración anexial izquierda de origen ovárico. Se realizó histerectomía total, ooforo-salpingectomía bilateral y omentectomía parcial. No se encontró evidencia de que la lesión se hubiese propagado más allá del ovario. El diagnóstico de linfoma no Hodking del tipo difuso de células B grandes difusas del ovario se realizó mediante examen histopatológico junto con inmunohistoquímica del tejido extirpado. El paciente recibió seis ciclos de quimioterapia. Después de 18 meses de seguimiento, la paciente continúa libre de enfermedad.

Appendiceal and ovarian Burkitt's lymphoma presenting as acute appendicitis

Abstract Burkitt's lymphoma is an extremely aggressive B-cell non-Hodgkin lymphoma. Patients with the sporadic form of Burkitt's lymphoma typically present with a rapidly growing abdominal mass, pain and distension. Involvement of either the appendix and/or ovaries in females is a rare manifestation of the disease. We present an unusual case of a 13 year old girl with appendiceal and ovarian Burkitt's lymphoma presenting with signs of acute appendicitis. This case demonstrates the potential for secondary involvement of the appendix and/or ovaries from Burkitt's lymphoma as well as the importance of the histopathology.

Thirty Years Cancer Incidence Data for Lahore, Pakistan: Trends and Patterns 1984-2014

This research was conducted to generate trends and patterns of most common male and female cancers from 1984-2014 for the city population of Lahore Pakistan. Cancer incidence data gathered for different organs were processed through cleaning, integration, transformation, reduction and mining for ultimate representation. Risk of cancer appeared to be continuously increasing among both males and females. Overall, lymphomas and breast cancer are the most common neoplasm in males and females, respectively, in Lahore with almost the highest rates in the Asian Pacific region. The incidence of head and neck, brain, and lung cancers, as well as leukemia have rapidly increased among males, whereas, ovarian, cervix, head and neck and lymphomas have become more common among females. The present communication should be helpful for adequate strategic planning, identification of risk factors and taking appropriate prevention and control measures at the national level.

Ovarian Torsion as an Unusual Presentation of Primary Bilateral Ovarian Lymphoma

AbstractPrimary ovarian involvement by Burkitt's lymphoma is rare and accounts for 0.5% of nonHodgkin lymphoma and 1.5% of ovarian tumors. We herein describe a very rare case of primary bilateral ovarian lymphoma in a 14-year-old presenting as ovarian torsion.

Abstract 33: Clinicopathologic, immunophenotypic, diagnostic, treatment characteristics of non-Hodgkin's lymphoma: Diffuse large B cell: Primary ovarian and with ovarian extensive involvement

Abstract 33: Clinicopathologic, immunophenotypic, diagnostic, treatment characteristics of non-Hodgkin's lymphoma: Diffuse large B cell: Primary ovarian and with ovarian extensive involvement

Comparative Cytotoxicity Study of Cisplatin and its Metabolites by using Brine Shrimp Lethality Bioassay

Background: Cisplatin an old chemotherapeutic agent used to treat various types of cancers, including sarcomas, some carcinomas e.g. small cell lung cancer and ovarian cancer, lymphomas and germ cell tumors etc. Most important toxicity of cisplatin is nephrotoxicity produced by cisplatin itself and its few metabolites, which are some time fatal.Objectives: Present study was to determined the comparative study and the level of toxicities of cisplatin and their metabolires by using Brine Shrimp Lethality Bioassay.Methods: In this study, cisplatin and its four possible metabolites (CM2 to CM5) were isolated from the 24 hours collected urines of 5 cisplatin treated cancer patients using conventional chromatographic techniques as well as HPLC, were placed to comparative cytotoxic study using brine shrimp lethality bioassay.Results: Comparative to cisplatin, its metabolites are more toxic, specially CM2 (Meta 2, LC50=1.2?gm/ml) and CM3 (LC50=1.08 ?gm/ml), CM4 (Meta 4, LC50=1.182?gm/ml) which is correlate to the previous study (p<0.01*).Conclusion: Cisplatin can form monohydrated complexes by hydrolytic reactions. The monohydrated complex is more toxic to the renal cells than cisplatin but it is not kidney specific.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 15-20

Abstract B41: REV7 is a possible prognostic predictor and a potential therapeutic target in human malignancy

Abstract Human REV7 (also known as MAD2L2 and MAD2B) is involved in DNA repair, cell cycle regulation, gene transcription and carcinogenesis, and is a key protein in translesion DNA synthesis. Here, we present our study to evaluate the significance of REV7 expression in human malignancy and its possibility to be a molecular target for cancer therapy. REV7 expression was assessed in epithelial ovarian cancer (EOC) and diffuse large B-cell lymphoma (DLBCL) by immunohistochemical staining. REV7 expression was detected in the majority of EOCs (92.0%) with especially high levels of expression frequently observed in ovarian clear cell carcinomas (CCCs) (73.5%) compared with that of non-CCCs (53.4%). Enhanced immunoreactivity to REV7 was associated with poor prognosis represented by reduced progression-free survival in advanced stage (stages II to IV) EOC. REV7 expression was also assessed in DLBCL, the most common type of non-Hodgkin lymphoma, in which high REV7 expression was associated with significantly shorter overall survival and progression-free survival. The effects of REV7 knockdown on cell proliferation and chemosensitivity in CCC cells were also analyzed in vitro and in vivo. REV7 knockdown in CCC cells decreased cell proliferation without affecting cell cycle distribution. Additionally, the number of apoptotic cells and DNA damaged cells were increased after cisplatin treatment. In a nude mouse tumor xenograft model, inoculated REV7-knockdown tumors showed significantly reduced tumor volumes after cisplatin treatment compared with those of the control group. These findings indicate that high REV7 expression is associated with poor prognosis in EOC and DLBCL, and depletion of REV7 enhances sensitivity to cisplatin treatment in CCC, suggesting that REV7 is a candidate for molecular target in human malignancy. Citation Format: Yoshiki Murakumo, Kaoru Niimi, Sosei Okina. REV7 is a possible prognostic predictor and a potential therapeutic target in human malignancy [abstract]. In: Proceedings of the AACR Special Conference on DNA Repair: Tumor Development and Therapeutic Response; 2016 Nov 2-5; Montreal, QC, Canada. Philadelphia (PA): AACR; Mol Cancer Res 2017;15(4_Suppl):Abstract nr B41.

Design, Synthesis and In Silico Molecular Docking Study of N-carbamoyl-6-oxo-1-phenyl-1, 6-dihydropyridine-3-carboxamide derivatives as Fibroblast growth factor 1 inhibitor

A novel series of N-carbamoyl-6-oxo-1-phenyl-1, 6-dihydropyridine-3-carboxamide derivatives (A1-A6) were synthesized by various substitution and their structures were confirmed by spectral and elemental analyses. The cytotoxic activity of the newly synthesized compounds was docked against fibroblast growth factor 1 (FGF1). These FGFR cascades play crucial roles in tumor cell proliferation, angiogenesis, migration, and survival. FGFRs were also identified in a variety of human cancers such as ovarian cancer, myeloproliferative syndromes, lymphomas, prostate and breast cancers as well as other malignant diseases. The molecular docking study was used for confirming their interaction with fibroblast growth factor 1. Thorough in silico molecular docking study, the result showed that all synthesized derivatives (A1-A6) have low binding energy (Table 1) and have good affinity toward their active pocket. Thus the synthesized derivatives considered as good anti cancer agents.

OP14.04: Ultrasound features in ovarian and uterine lymphomas

OP14.04: Ultrasound features in ovarian and uterine lymphomas

Ovarian Non-Hodgkin's Lymphoma from a Regional Cancer Centre in South India

Ovarian Non-Hodgkin's Lymphoma from a Regional Cancer Centre in South India

Primary ovarian Burkitt lymphoma: a case report and literature review

目的 探讨原发性伯基特淋巴瘤（BL）的临床病理和免疫表型特征。 方法 对1例散发性卵巢BL患者肿瘤组织进行病理形态学、免疫组织化学检测，并结合临床特征进行临床病理分析。 结果 患者，36岁。光学显微镜下BL瘤细胞呈弥漫一致的中等大细胞，伴有星空现象和多量的核碎片，易见核分裂象。免疫表型示瘤细胞CD20+和（或）CD79a+、Ki-67+++，bcl-2、TdT和MPO均阴性。 结论 BL属高度恶性淋巴瘤，主要应与淋巴母细胞性淋巴瘤、髓系白血病及非淋巴造血系统小细胞恶性肿瘤等相鉴别。

Family History of Cancer in Relation to Breast Cancer Subtypes in African American Women.

The evidence on the relation of family history of cancers other than breast cancer to breast cancer risk is conflicting, and most studies have not assessed specific breast cancer subtypes. We assessed the relation of first-degree family history of breast, prostate, lung, colorectal, ovarian, and cervical cancer and lymphoma or leukemia, to the risk of estrogen receptor-positive (ER(+)), ER(-), and triple-negative breast cancer in data from the African American Breast Cancer Epidemiology and Risk Consortium. Multivariable logistic regression models were used to calculate ORs and 95% confidence intervals (CI). There were 3,023 ER(+) and 1,497 ER(-) breast cancer cases (including 696 triple-negative cases) and 17,420 controls. First-degree family history of breast cancer was associated with increased risk of each subtype: OR = 1.76 (95% CI, 1.57-1.97) for ER(+), 1.67 (1.42-1.95) for ER(-), and 1.72 (1.38-2.13) for triple-negative breast cancer. Family history of cervical cancer was associated with increased risk of ER(-) (OR = 2.39; 95% CI, 1.36-4.20), but not ER(+) cancer. Family history of both breast and prostate cancer was associated with increased risk of ER(+) (3.40; 2.42-4.79) and ER(-) (2.09; 1.21-3.63) cancer, but family history of both breast and lung cancer was associated only with ER(-) cancer (2.11; 1.29-3.46). A family history of cancers other than breast may influence the risk of breast cancer, and associations may differ by subtype. Greater surveillance and counseling for additional screening may be warranted for women with a family history of cancer.

Abstract A60: DOK1 gene may act as a tumor suppressor in breast cancer

Abstract The DOK1 (Downstream of Tyrosine kinase 1) gene is a putative tumor suppressor gene located on human chromosome 2p13 which is frequently rearranged in leukaemia and other human tumours. The DOK1 protein is a member of the Dok protein family comprising seven members. It inhibits MAP kinase activity and displays anti-proliferative activities. The DOK1 gene may act as a tumor suppressor gene in ovarian cancer, Burkitt lymphoma, head and neck cancer (HNC), chronic lymphocytic leukaemia (CLL) and lung cancer by inhibiting cell proliferation. So far there is no study in the literature analyzing the relationship between the DOK1 gene and breast cancer. The aim of this study was to investigate the role of the DOK1 gene in breast cancer. The tumors and adjacent normal tissues were collected from 50 patients who underwent surgery for breast cancer at the Bezmialem Vakif University Medical Faculty. For expression analysis, after isolation of RNA cDNA was been obtained. Gene expression levels in the tumors and adjacent normal tissues were determined by quantitative RT-PCR using the 2-ΔΔCT method. The results were normalized using the G6PD gene as reference. For mutation analysis, DNA was isolated and analyzed by cycle sequencing to detect mutations. The SPSS 21.0 software package was used for statistical analysis. P<0.05 was considered significant. When the DOK1 expression levels in the tumors and adjacent normal tissues were compared we observed that DOK1 expression was decreased in 31 (62%) patients and increased in 16 (32%) patients. The decrease of DOK1 expression was associated with age (p=0.031), menopausal status (p=0.017), histologic type, (p=0.015) and stage (p=0.017). We identified 11 different alterations in the non-coding regions of the gene. One of these alterations was in the 5'-UTR and the remaining 10 were located in the introns 1 and 4. We did not observe any significant association between the mutations and expression level of the DOK1 gene. Our results, suggest that the DOK1 gene might act as a tumor suppressor in breast cancer. Citation Format: Nur Buyru, Esin Tuna, Filiz Ozdemir, Pelin Bulut, Nejat Dalay. DOK1 gene may act as a tumor suppressor in breast cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research; Oct 17-20, 2015; Bellevue, WA. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(2_Suppl):Abstract nr A60.

Primary ovarian lymphoma and benign Brenner tumor

Primary ovarian lymphoma and benign Brenner tumor