Primary Ovarian Non-Hodgkin’s Lymphoma with Late Diagnosis Due to Unusual Presentation - A Case Report

Involvement of NHL in ovary is seen in disseminated Lymphoma but primary ovarian lymphoma still not commonly seen. We presented the case where the patient had suffered for unexplained fever for more than 1 year and lately presented with gross weight loss as well as painless lower abdominal lump. CT scan showed a huge heterogeneous mass of about 15x12.4cm in pelvic cavity with mild ascites. Surgery was performed in view of ovarian neoplasm as CA125 was also raised. Histopathology confirmed the diagnosis of diffuse large B cell lymphoma with Immunohistochemistry confirmation.

Treated with R-CHOP protocol for 6 cycles as IHC expressed CD20 positive. Post chemotherapy follow up PET scan showed complete response of treatment, though in spite of all treatment Primary ovarian lymphoma have a poor outcome with a range from 0% to 36% expected to survive for less than three years.

Primary Ovarian Lymphoma is difficult to diagnose early due to its location, but most of the time with the presence of B symptoms patients’ need further evaluation which leads to make the diagnosis. For confirmation the diagnosis with IHC, Surgery has no alternative way. But chemotherapy plays an important role to treat the cases as like as nodal lymphoma. Rituximab combination with CHOP regimen remains standard protocol in case of CD20 Positive cases. In spite of all treatment Primary ovarian lymphoma have a poor outcome with a range from 0% to 36% expected to survive for less than three years