Primary Ovarian Non-Hodgkin's Lymphoma: Outcome after Treatment with Combination Chemotherapy

doi:10.1006/gyno.1996.4583

Gynecologic Oncology

Volume 64, Issue 3, March 1997, Pages 446-450

https://doi.org/10.1006/gyno.1996.4583 Get rights and content

Abstract

Because the outcome of patients with primary ovarian non-Hodgkin's lymphoma (NHL) is controversial, we retrospectively analyzed experience with adults seen at the University of Texas M. D. Anderson Cancer Center from 1974 to 1993. Patients were included if at least one ovary was pathologically involved, and if combination chemotherapy was used that must have included doxorubicin for intermediate grade histologies. We identified 15 patients who constituted 0.5% of all untreated NHL and 1.5% of untreated ovarian neoplasms that presented to our instutition during this time. One patient refused therapy, leaving 14 assessable for response. Nine patients had intermediate-grade, 5 had high-grade, and none had low-grade NHL. One ovary was involved in 4 patients, and both in 10, in 7 of whom additional sites were involved, including supradiaphragmatic nodes in 2. Four patients had AAS I and 10 had AAS IV. Favorable (0 or 1) and unfavorable (>1) IPI scores were seen in 5 and 9 patients, respectively. The complete remission rate for all patients was 64%, and 5-year survival and FFS for all assessable patients were 57 and 46%, respectively. We conclude that the complete remission rate and FFS of patients with ovarian NHL treated with appropriate chemotherapy appear to be similar to that of patients with other nodal NHLs. Further work is required to determine prognostic factors in ovarian NHL.

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Ovarian lymphoma, whether a primary or secondary condition, is very rare. Little is known about its genetic aberrations. Here, we reviewed the clinical, morphological and immunohistochemical characteristics of nine ovarian diffuse large B-cell lymphoma (DLBCL) cases and performed fluorescence in situ hybridisation (FISH) analysis to detect MYC, BCL2 and BCL6 translocations. We also performed whole exome sequencing analysis to determine their genomic features compared with those of conventional extranodal DLBCL. The results showed that six of nine cases were bilateral and three cases were left-sided. Histologically, the tumour cells were homogeneous and a starry-sky pattern was very common in ovarian DLBCL (Burkitt-like). Immunohistochemically, most of the cases (7/9) were germinal centre B-cell-like (GCB) subtype, and dual expression of MYC and BCL2 was found in three cases of ovarian DLBCL. A double-hit (involving MYC and BCL6) phenotype was found in one case of ovarian DLBCL (GCB subtype). Sequencing analysis revealed that NOTCH4, NCOR2, BCL10 and CARD11 were frequently mutated both in ovarian DLBCL and conventional extranodal DLBCL. COL27A1, PRKCB, HLA-A, NOTCH3 and HDAC4 mutations were found only in ovarian DLBCL but not in conventional DLBCL, and NOTCH3 and HDAC4 mutations were only identified in the GCB subtype. Furthermore, several signalling pathways including the B-cell receptor, Epstein–Barr virus infection, HTLV-1 infection, Notch, PI3K-AKT and mTOR were found to be involved in ovarian DLBCL. Our results broaden the understanding of the clinicopathological and molecular characteristics of ovarian DLBCL and compare their genetic features to those of conventional extranodal DLBCL for the first time.
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La découverte d'un lymphome dans un tératome est extrêmement rare : seuls cinq cas avaient été rapportés avant celui-ci. Une revue de la littérature a montré qu'il existait des théories très variées sur la pathogenèse et la prise en charge de cette affection.
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¹: To whom correspondence should be addressed at Section of Lymphoma, Box 68, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030. Fax: (713) 794-5656.

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Regular ArticlePrimary Ovarian Non-Hodgkin's Lymphoma: Outcome after Treatment with Combination Chemotherapy

Abstract

Am J Obstet Gynecol

Gynecol Oncol

Ann Oncol

Cell

Blood

Blood

Malignant reticuloendothelial disease involving the ovary as a primary manifestation: A series of 19 lymphomas and 1 granulocytic sarcoma

Cancer

Malignant lymphoma with primary manifestation in the gonad: A clinicopathologic study of 38 patients

Cancer

Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases

Cancer

Malignant lymphoma presenting as an ovarian tumour: A clinicopathological analysis of 34 cases

Br J Obstet Gynaecol

Regular Article
Primary Ovarian Non-Hodgkin's Lymphoma: Outcome after Treatment with Combination Chemotherapy