DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201834

Pyrexia of unknown origin: a rare presentation of primary ovarian lymphoma

Asha N. Gokhale, Akriti Agarwal, Bharat D. Purandare

Abstract


It is very rare to have a lymphomatous involvement of ovary. Malignant lymphoma of ovary is a well-known late manifestation of disseminated nodal disease. Primary ovarian lymphoma with ovarian mass as an initial manifestation is a rare entity and may have varied presentations which can cause confusion to the physician and cause delay in diagnosis. Study presents a case of non-Hodgkin’s lymphoma where the initial presentation was fever with weight loss, and was evaluated as pyrexia of unknown origin. When no other cause of fever was identified PET-CT was done showing metabolically active uterine mass with no lymphadenopathy. Exploratory laparotomy was planned followed by hysterectomy with bilateral salpingo ophorectomy with omentectomy. Ovarian malignancy was detected intraoperatively, which was diagnosed as diffuse large B cell lymphoma, NHL double expresser phenotype on histopathology and IHC. Patient was started on chemotherapy and is doing fine.


Keywords


Diffuse large B cell lymphoma, Primary ovarian lymphoma, Pyrexia of unknown origin

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References


Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of unknown origin: an evidence-based review. Am J Med Sci. 2012;344(4):307-16.

Cunha BA. Fever of unknown origin: clinical overview of classic and current concepts. Infect Dis Clin North Am. 2007;21(4):867-915.

Ekanayake CD, Punchihewa R, Wijesinghe PS. An atypical presentation of an ovarian lymphoma: a case report. J Med Case Reports. 2018;12(1):338.

Osborne BM, Robboy SJ. Lymphoma or Leukaemia Presenting as ovarian Tumours: An analysis of 42 cases. Cancer. 1983;52:1933-43.

Elharroudi T, Ismaili N, Errihani H, Jalil A. Primary lymphoma of the ovary. J Cancer Res Ther. 2008;4:195-6.

Chorlton I, Norris HJ, King FM. Malignant reticuloendothelial disease involving the ovary as a primary manifestation. A series of 19 lymphomas and 1 granulocytic sarcoma. Cancer. 1974;34(2):397-407.

Crasta JA, Vallikad E. Ovarian lymphoma. Indian J Med Pediatric Oncol. 2009;30:28-30.

Fox H, Langley FA, Govan ADT, Hill SA, Bennett MH. Malignant lymphoma presenting as an ovarian tumour: a clinicopathological analysis of 34 cases. Br J Obstet Gynaecol. 1988;95(4):386-90.

Vang R, Medeiros LJ, Warnke RA, Higgins JP, Deavers MT. Ovarian non-Hodgkin’s lymphoma: A clinicopathologic study of eight primary cases. Mod Pathol. 2001;14:1093-99.

Senol T, Doger E, Kahramanoglu I. Five cases of Non-Hodgkin B-cell Lymphoma of the Ovary. Case Rep Obst Gyn. 2014;1:Article ID 392758.

Vang R, Medeiros LJ, Fuller GN, Sarris AH, Deavers M. Non-Hodgkin’s lymphoma involving the gynecologic tract. A review of 88 cases. Adv Anat Pathol. 2001;8:200-17.

Kaur N, Kaushi KR, Gulati A, Kaushal V, Chahal JS. Non-Hodgkin’s Lymphoma presenting as an ovarian mass. Clin Cancer Invest J. 2014;3:231-4.

Komoto D, Nishiyama Y, Yamamoto Y, Monden T, Sasakawa Y, Toyama Y, et al. A case of non-Hodgkin’s lymphoma of the ovary: Usefulness of 18F-FDG PET for staging and assessment of the therapeutic response. Ann Nucl Med. 2006;20:157-60.