Abdominal B-cell lymphoma mimicking ovarian cancer
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Abstract
A 54-year-old patient presented in our clinic with pressure in the upper abdomen, dyspnea
and abdominal distension. The clinical examination showed pleural effusion, ascites and an enlarged
axillary lymph node on the right side. In gynecological sonography ascites, an ovarian cyst and
peritoneal carcinosis in the pouch of Douglas were detected, which were potentially indicative of
ovarian cancer. A staging laparoscopy was performed to confirm the diagnosis of ovarian cancer and
to evaluate operability. Intraoperatively white milky ascites, white-yellow marbling of the liver and
white stipple bedding on the diaphragm and liver were detected. The ovaries and the fallopian tubes
were tumorously enlarged. Biopsies were taken from the right fimbrial funnel, the liver around the
falciform ligament and the diaphragm. Histology of all abdominal biopsies and the axillary lymph
node revealed high lymphatic infiltration matching a stage III B-cell-lymphoma. The patient was
transferred to the hemato-oncological department for further therapy. Six cycles of cytostatic therapy
with R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, prednisone)
were initiated. The patient is doing well and in stable disease 6 months after completion of cytotoxic
therapy. This case report presents a rare case of manifestation of an extra nodal B-cell-lymphoma
with abdominal presentation that mimicked ovarian cancer.