primary ovarian lymphoma

Primary ovarian lymphoma (POL) refers to involvement of the ovary with lymphoma but without the involvement of any other site. It is an extremely rare yet well-recognized condition.

Epidemiology

POL accounts for ~1.5% of ovarian tumors .

Pathology

The rarity of this condition is probably in part due to the lack of lymphoid tissue in the normal ovary . In almost all instances, cases tend to be non-Hodgkin lymphoma (~0.5% of NHL tends to involve the ovary ) with diffuse large B-cell lymphoma (DLBCL) being a dominant histological type . Burkitt lymphoma has also been infrequently described.

Radiographic features

Ultrasound

Imaging features are usually non-specific on ultrasound.

CT

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 .

MRI

Tends to be of a relatively homogenous signal. Described signal characteristics include :

  • T1: hypointense
  • T2: slightly hyperintense
Staging

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 tumors of the ovary.

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