Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases

Introduction: The involvement of the Female Genital Tract (FGT) by lymphoma is extremely rare, with ovaries being most commonly affected. Less than 1% of lymphomas present with ovarian involvement and less than 1.5% of ovarian neoplasms are of lymphoid origin. Secondary involvement of ovary by s...

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Main Authors: Nikita Mulchandani, Suma Mysore Narayana, Chennagiri S Premalata, Mohit Agrawal, Venkateshaiah Reddihalli Pallavi
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2021-08-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/15235/50649_CE[Ra1]_F[SK]_PF1(SC_OM)_PFA(SC_KM)_PN(KM).pdf
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author Nikita Mulchandani
Suma Mysore Narayana
Chennagiri S Premalata
Mohit Agrawal
Venkateshaiah Reddihalli Pallavi
author_facet Nikita Mulchandani
Suma Mysore Narayana
Chennagiri S Premalata
Mohit Agrawal
Venkateshaiah Reddihalli Pallavi
author_sort Nikita Mulchandani
collection DOAJ
description Introduction: The involvement of the Female Genital Tract (FGT) by lymphoma is extremely rare, with ovaries being most commonly affected. Less than 1% of lymphomas present with ovarian involvement and less than 1.5% of ovarian neoplasms are of lymphoid origin. Secondary involvement of ovary by systemic lymphoma is more common than Primary Ovarian Lymphomas (POL) which is usually Primary Ovarian Non-Hodgkin lymphoma (PONHL) of B-cell lineage. Aim: To understand the clinicopathological and immunomorphological features of Primary Ovarian Non-Hodgkin lymphoma. Materials and Methods: This was a descriptive retrospective study conducted at Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka. India, for a duration of 14 years between July 2006 to June 2020. Eight cases of PONHL were identified from departmental archives and clinicopathological and Immunohistochemistry (IHC) findings of these tumours were analysed. Results: The PONHL constituted 0.4% of all Non-Hodgkin lymphoma (NHL) reported during the study period. The patients age ranged from 13-60 years with a mean age of 34 years. Among eight cases of PONHL, two cases were of Diffuse Large B-Cell Lymphoma (DLBCL), followed by one case each of High-Grade B-Cell Lymphoma, Not Otherwise Specified (HGBL, NOS), Follicular Lymphoma (FL), Burkitt Lymphoma (BL), Plasmablastic Lymphoma (PBL), Precursor B-Lymphoblastic Lymphoma (B-LBL), and precursor T-Lymphoblastic Lymphoma (T-LBL). Seven cases were staged IE (Ann Arbor staging system) while one case was designated as stage IIE. Conclusion: This was probably the first study on PONHL from India. The diagnosis of PONHL is challenging unless there is a high index of suspicion as these patients present with non specific pelvic symptoms and can be misdiagnosed as other epithelial, stromal or germ cell ovarian neoplasm which differs in treatment and prognosis. Histological examination with IHC and molecular testing are essential to establish a diagnosis.
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spelling doaj.art-1142582e4b884863b0cd1b952fa447b92022-12-21T23:14:26ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-08-01158EC05EC1110.7860/JCDR/2021/50649.15235Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight CasesNikita Mulchandani0Suma Mysore Narayana1Chennagiri S Premalata2Mohit Agrawal3Venkateshaiah Reddihalli Pallavi4Registrar, Department of Pathology, Apollo Cancer Centre Chennai, Tamil Nadu, India.Associate Professor, Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.Professor and Head, Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.Senior Resident, Department of Pathology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India.Professor and Head, Department of Gynaecologic Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.Introduction: The involvement of the Female Genital Tract (FGT) by lymphoma is extremely rare, with ovaries being most commonly affected. Less than 1% of lymphomas present with ovarian involvement and less than 1.5% of ovarian neoplasms are of lymphoid origin. Secondary involvement of ovary by systemic lymphoma is more common than Primary Ovarian Lymphomas (POL) which is usually Primary Ovarian Non-Hodgkin lymphoma (PONHL) of B-cell lineage. Aim: To understand the clinicopathological and immunomorphological features of Primary Ovarian Non-Hodgkin lymphoma. Materials and Methods: This was a descriptive retrospective study conducted at Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka. India, for a duration of 14 years between July 2006 to June 2020. Eight cases of PONHL were identified from departmental archives and clinicopathological and Immunohistochemistry (IHC) findings of these tumours were analysed. Results: The PONHL constituted 0.4% of all Non-Hodgkin lymphoma (NHL) reported during the study period. The patients age ranged from 13-60 years with a mean age of 34 years. Among eight cases of PONHL, two cases were of Diffuse Large B-Cell Lymphoma (DLBCL), followed by one case each of High-Grade B-Cell Lymphoma, Not Otherwise Specified (HGBL, NOS), Follicular Lymphoma (FL), Burkitt Lymphoma (BL), Plasmablastic Lymphoma (PBL), Precursor B-Lymphoblastic Lymphoma (B-LBL), and precursor T-Lymphoblastic Lymphoma (T-LBL). Seven cases were staged IE (Ann Arbor staging system) while one case was designated as stage IIE. Conclusion: This was probably the first study on PONHL from India. The diagnosis of PONHL is challenging unless there is a high index of suspicion as these patients present with non specific pelvic symptoms and can be misdiagnosed as other epithelial, stromal or germ cell ovarian neoplasm which differs in treatment and prognosis. Histological examination with IHC and molecular testing are essential to establish a diagnosis.https://jcdr.net/articles/PDF/15235/50649_CE[Ra1]_F[SK]_PF1(SC_OM)_PFA(SC_KM)_PN(KM).pdfextra-nodalfemale genital tract tumourshigh-grade b-cell lymphomaovarian lymphomaovarian solid tumours
spellingShingle Nikita Mulchandani
Suma Mysore Narayana
Chennagiri S Premalata
Mohit Agrawal
Venkateshaiah Reddihalli Pallavi
Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
Journal of Clinical and Diagnostic Research
extra-nodal
female genital tract tumours
high-grade b-cell lymphoma
ovarian lymphoma
ovarian solid tumours
title Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
title_full Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
title_fullStr Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
title_full_unstemmed Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
title_short Primary Ovarian Non-Hodgkin Lymphoma- A Diagnostic Challenge with Clinicopathological: Clinicopathological Study of Eight Cases
title_sort primary ovarian non hodgkin lymphoma a diagnostic challenge with clinicopathological clinicopathological study of eight cases
topic extra-nodal
female genital tract tumours
high-grade b-cell lymphoma
ovarian lymphoma
ovarian solid tumours
url https://jcdr.net/articles/PDF/15235/50649_CE[Ra1]_F[SK]_PF1(SC_OM)_PFA(SC_KM)_PN(KM).pdf
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AT chennagirispremalata primaryovariannonhodgkinlymphomaadiagnosticchallengewithclinicopathologicalclinicopathologicalstudyofeightcases
AT mohitagrawal primaryovariannonhodgkinlymphomaadiagnosticchallengewithclinicopathologicalclinicopathologicalstudyofeightcases
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