Primary ovarian lymphoma (POL) refers to involvement of the ovary with lymphoma but without involvement of any other site. It is an extremely rare yet well recognised condition.
POL accounts for ~1.5% of ovarian tumours 5.
The rarity of this condition is probably contributed by lack of lymphoid tissue in the ovary 4-5. In almost all of cases instances it tends to comprise of non-Hodgkin lymphoma (~0.5% of NHL tends to involve the ovary 5) with diffuse large B-cell lymphoma (DLBCL) being a dominant histological type 2. Burkitt lymphoma has also been infrequently described .
Once the diagnosis is made CT is the preferred imaging modality of ongoing assessment particularly for staging purposes. Often tends to be hypoattenuating on CT with mild enhancement post contrast 4.
Imaging features are usually non specific on ultrasound.
Tends to be of relatively homogenous signal
Described signal characteristics include 4:
- T1: hypointense
- T2: slightly hyperintense
This is one of the rare situations where the FIGO staging system is not used. Instead the standard non-Hodgkin lymphoma staging system is used.
Treatment and prognosis
The prognosis generally tends to be better than for other primary tumours of the ovary.
- overview of lymphoma
WHO classification of tumours of haematopoietic and lymphoid tissues
- Hodgkin lymphoma
mature B-cell lymphoma
- Burkitt lymphoma
- follicular lymphoma
- lymphoplasmacytic lymphoma (Waldenström's macroglobulinaemia)
- lymphomatoid granulomatosis
- mantle cell lymphoma
- mature T-cell and NK-cell lymphoma
- post-transplant lymphoproliferative/lymphoproliferation disorders
- mature B-cell lymphoma
- location-specific lymphomas
- central nervous system
- head and neck lymphoma
- thoracic lymphoma
- gastrointestinal lymphoma
- hepatobiliary lymphoma
- genitourinary lymphoma
- musculoskeletal lymphoma
- cutaneous lymphoma
- lymphoma staging
- 1. Kapetanakis V, Karlin NJ, Mccullough AE et-al. Primary ovarian malignant lymphoma presenting as ovarian carcinomatosis: a case report and literature review. Eur. J. Gynaecol. Oncol. 2010;31 (6): 701-2. - Pubmed citation
- 2. Zhao XY, Hong XN, Cao JN et-al. Clinical features and treatment outcomes of 14 cases of primary ovarian non-Hodgkin's lymphoma: a single-center experience. Med. Oncol. 2010;doi:10.1007/s12032-010-9578-0 - Pubmed citation
- 3. Dao AH. Malignant lymphoma of the ovary: report of a case successfully managed with surgery and chemotherapy. Gynecol. Oncol. 1998;70 (1): 137-40. doi:10.1006/gyno.1998.5033 - Pubmed citation
- 4. Crasta JA, Vallikad E. Ovarian lymphoma. Indian J Med Paediatr Oncol. 2009;30 (1): 28-30. doi:10.4103/0971-5851.56333 - Free text at pubmed - Pubmed citation
- 5. Crawshaw J, Sohaib SA, Wotherspoon A et-al. Primary non-Hodgkin's lymphoma of the ovaries: imaging findings. Br J Radiol. 2007;80 (956): e155-8. doi:10.1259/bjr/35049074 - Pubmed citation
- 6. Elharroudi T, Ismaili N, Errihani H et-al. Primary lymphoma of the ovary. J Cancer Res Ther. 4 (4): 195-6. J Cancer Res Ther (link) - Pubmed citation
- 7. Vang R, Medeiros LJ, Warnke RA et-al. Ovarian non-Hodgkin's lymphoma: a clinicopathologic study of eight primary cases. Mod. Pathol. 2001;14 (11): 1093-9. doi:10.1038/modpathol.3880442 - Pubmed citation