Table of Contents
Definition / general | Clinical features | Diagnosis | Laboratory | Radiology description | Radiology images | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology images | Positive stains | Negative stains | Differential diagnosisCite this page: Gupta N. Lymphoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorlymphoma.html. Accessed June 1st, 2020.
Definition / general
- Can be primary or secondary
- Arises from hilar lymphoid tissue or ovarian teratoma
Clinical features
- Pelvic pain, pelvic mass, and urinary frequency and incontinence
- Ages 6 to 74 years
- Usually B cell type
- Children: usually Burkitt lymphoma
- Adults: usually diffuse large B cell or follicular lymphoma (Adv Anat Pathol 2001;8:200)
- May be difficult to determine if primary or secondary
- Primary ovarian tumors have better prognosis (Gynecol Oncol 2004;95:750)
- 5 year survival is 80% after surgery or chemotherapy in primary disease vs. 33% in secondary disease (Mod Pathol 2001;14:1093, Am J Surg Pathol 1993;17:154, Arch Pathol Lab Med 1994;118:647)
Diagnosis
- Fox et al. proposed 3 criteria for the diagnosis of primary ovarian lymphoma (Br J Obstet Gynaecol 1988;95:386):
- Confined to ovarian regional lymph nodes or adjunctive organs at diagnosis
- No abnormal cells in bone marrow or peripheral blood, and
- Any extraovarian disease must occur at least a few months after the appearance of the ovarian lesions
Laboratory
- Normal serum CEA, CA125, CA19–9
Radiology description
- USG shows homogeneous, hypoechoic, solid cystic mass (Radiol Med 1998;95:493)
Radiology images
Images hosted on other servers:
Abdominopelvic tumor
Prognostic factors
- Histologic type is most important prognostic factor
- B cell tumors associated with longer survival (Gynecol Oncol 2003;90:215)
Case reports
- 23 year old woman with diffuse large B cell lymphoma, spindle cell variant (Arch Pathol Lab Med 2003;127:e169)
- 38 year old woman with primary ovarian diffuse large B cell lymphoma (Case Rep Obstet Gynecol 2013;2013:493836)
- 50 year old woman with diffuse large B cell lymphoma (Case #295)
Treatment
- Based on histology, type, and clinical staging
- Surgery, chemotherapy (CHOP or Rituxan-CHOP) or radiotherapy
Gross description
- Mostly unilateral
- Microscopic to 15 cm
- Solid whitish fleshy mass
Gross images
Case #295, AFIP images
Diffuse large B cell lymphoma
Burkitt's lymphoma
Lobulation and cream color
Images hosted on other servers:
Bilateral ovarian tumors
Primary ovarian lymphoma
Microscopic (histologic) description
- Burkitt lymphoma tends to grow in cords or nests forming pseudoacini, accompanied by sclerosis and resembling carcinoma
- Diffuse large cell lymphoma may appear as short fascicles and form interlacing bundles of spindle cells, resembling a stromal tumor; has diffuse pattern of tumor cells with large vesicular nuclei and prominent nucleoli
Microscopic (histologic) images
Case #295, AFIP images
Cords arrangement
Nests
Alveolar pattern
Various images
CD20
Ki-67
Follicular lymphoma
Large cell lymphoma
Images hosted on other servers:
Diffuse large B cell lymphoma:
Monotonous medium cells
Hyperchromatic nuclei
Diffuse growth pattern
H&E, CD20 (fig 3), CD3 (fig 4)
CD20
LCA
Negative for PLAP
Cytology images
Case #295
Diffuse large B cell lymphoma
Positive stains
- Burkitt lymphoma: CD20 and BCL6
- Diffuse large B cell lymphoma: CD45/LCL, CD20, BCL6, variable CD10 and BCL2
- Follicular lymphoma: CD20, BCL6, CD10
- Anaplastic large T cell lymphoma: CD3, CD10, CD30, CD43, CD99, TdT; negative for ALK1 and BCL6
- Pre-T lymphoblastic lymphoma: CD3, CD10, CD99, TdT; negative for BCL6
Negative stains
- CA125, cytokeratin, ER, PR
Differential diagnosis
- Adult granulosa cell tumor: Call-Exner bodies, CD45/LCA negative
- Dysgerminoma: CD45/LCA negative
- Granulocytic sarcoma
- Small cell carcinoma of hypercalcemic type: CD45/LCA negative
