Ovarian ALK+ diffuse large B-cell lymphoma: a case report and a review of the literature

Int J Gynecol Pathol. 2013 Sep;32(5):471-5. doi: 10.1097/PGP.0b013e31826cbd6e.

Abstract

Through this case presentation and a review of the literature, we aim to describe clinical and pathologic features and to distinguish the outcome of these tumors. A 25-year-old woman presented with pelvic pain and an iliac mass. Workup revealed a 53-mm cystic partitioned mass of the left ovary infiltrating the left sacrum. She underwent a left adnexectomy. Gross examination revealed a ruptured ovarian mass. When dissected, it showed grayish cerebroid aspects. Histologic examination revealed a malignant tumor proliferation of the diffuse large cells. An immunohistochemical analysis showed negative results for PLAP, αFP, βHCG, CD117, CK20, and CD30. It also showed lack of B markers and T marker (CD3) and an expression of CD138 and anaplastic lymphoma kinase. The patient was treated by 6 cycles of CHOP chemotherapy and a pelvic radiotherapy. She presented with a 15-cm splenomegaly 26 months later and died of febrile neutropenia. Most patients follow an aggressive disease and are unlikely to respond to the standard.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Biomarkers, Tumor / metabolism*
  • Cell Differentiation
  • Cyclophosphamide / administration & dosage
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • Fatal Outcome
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphoma, B-Cell / pathology*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / surgery
  • Prednisone / administration & dosage
  • Receptor Protein-Tyrosine Kinases / metabolism*
  • Vincristine / administration & dosage

Substances

  • Biomarkers, Tumor
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases
  • Prednisone

Supplementary concepts

  • CHOP protocol