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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2011; 32(04): 207-210
DOI: 10.4103/0971-5851.95142
CASE REPORT

A case of primary ovarian lymphoma with autoimmune hemolytic anemia achieving complete response with Rituximab-based combination chemotherapy

N S Ghadyalpatil
Department of Medical Oncology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
,
R Chandrasekar
Department of Radiology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
,
D Snehalatha
Department of Pathology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
,
B M Reddy
Department of General Surgery, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
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Abstract

Ovarian involvement as primary or secondary lymphomatous process is extremely uncommon. In most cases, the diagnosis is usually not suspected initially and is confirmed only after detailed histopathological evaluation. We report a patient with primary ovarian diffuse large B-cell lymphoma (DLBCL) and associated auto-immune hemolytic anemia (AIHA) who achieved complete remission after treatment with Rituximab-cyclophosphamide-doxorubicin-vincristine and prednisolone (R-CHOP) chemotherapy. This patient was a 50 year old female, who presented with fever, abdominal pain, vomiting, weight loss and anemia. Computed tomography scan of the abdomen and pelvis revealed a large left ovarian mass with bilateral hydronephrosis. We performed exploratory laparotomy and partial resection of the mass was done due to the adhesions. Histopathology confirmed the diagnosis of DLBCL. After six R-CHOP chemotherapy cycles, patient achieved complete response with correction of anemia. To our knowledge, this may be the first case report till date of primary ovarian DLBCL with AIHA treated with R-CHOP chemotherapy who achieved complete remission in terms of primary disease as well as hemolytic anemia.

Keywords

Hemolytic anemia - ovarian lymphoma - Rituximab


Publication History

Article published online:
06 August 2021

© 2011. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Dimopoulos MA, Daliani D, Pugh W, Gershenson D, Cabanillas F, Sarris AH. Primary ovarian non-Hodgkin′s lymphoma: Outcome after treatment with combination chemotherapy. Gynecol Oncol 1997;64:446-50.
  • 2 Osborne BM, Robboy SJ. Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases. Cancer 1983;52:1933-43.
  • 3 Lagoo AS, Robboy SJ. Lymphoma of the female genital tract: Current status. Int J Gynecol Pathol 2006;25:1-21.
  • 4 Kosari F, Daneshbod Y, Parwaresch R, Krams M, Wacker HH. Lymphomas of the female genital tract: A study of 186 cases and review of the literature. Am J Surg Pathol 2005;29:1512-20.
  • 5 Woodruff JD, NoliCastillord, Novak ER. Lymphoma of the ovary. A study of 35 cases from the Ovarian Tumor Registry of the American Gynecological Society. Am J Obstet Gynecol 1963;85:912-8.
  • 6 Hauswirth AW, Skrabs C, Schützinger C, Gaiger A, Lechner K, Jäger U. Autoimmune hemolytic anemias, Evans′ syndromes, and pure red cell aplasia in non-Hodgkin lymphomas. Leuk Lymphoma 2007;48:1139-49.
  • 7 Ambulkar I, Nair R. Primary ovarian lymphoma: Report of cases and review of literature. Leuk Lymphoma 2003;44:825-7.
  • 8 Monterroso V, Jaffe ES, Merino MJ, Medeiros LJ. Malignant lymphomas involving the ovary: A clinicopathologic analysis of 39 cases. Am J Surg Pathol 1993;17:154-70.
  • 9 Skodras G, Fields V, Kragel PJ. Ovarian lymphomas and serous carcinoma of low malignant potential arising in the same ovary: A case report with literature review of primary ovarian lymphoma. Arch Pathol Lab Med 1994;118:647-50.
  • 10 Ferry JA, Young RH. Malignant lymphomas, pseuso lymphomas and hematopoeitic disorders of the female genital tract. Pathol Ann 1991;26:227-63.
  • 11 Moreno C, Hodgson K, Ferrer G, Elena M, Filella X, Pereira A, et al. Autoimmune cytopenia in chronic lymphocytic leukemia: Prevalence, clinical associations, and prognostic significance. Blood 2010;116:4771-6.
  • 12 Eve HE, Rule SA. Autoimmune haemolyticanaemia associated with mantle cell lymphoma. Int J Hematol 2010;91:322-5.
  • 13 McKelvey EM, Gottlieb JA, Wilson HE, Haut A, Talley RW, Stephens R, et al. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer 1976;38:1484-93.
  • 14 Kim KM, Yoon DH, Lee SG, Lim SN, Sug LJ, Huh J, et al. A case of primary adrenal diffuse large B-cell lymphoma achieving complete remission with Rituximab -CHOP chemotherapy. J Korean Med Sci2009;24:525-8.
  • 15 Ferreri AJ, Dognini GP, Bairey O, Szomor A, Montalbán C, Horvath B, et al. The addition of rituximab to anthracycline-based chemotherapy significantly improves outcome in ′Western′ patients with intravascular large B-cell lymphoma. Br J Haematol 2008;143:253-7.
  • 16 Rajnics P, Demeter J, Csomor J, Krenács L, Pajor L, Kollár B, et al. Rare primary extranodal lymphomas: Diffuse large B-cell lymphomas of the genital tract. Ann Hematol 2009;88:1223-8.
  • 17 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.
  • 18 Signorelli M, Maneo A, Cammarota S, Isimbaldi G, Garcia Parra R, Perego P, et al. Conservative management in primary genital lymphomas: The role of chemotherapy. Gynecol Oncol 2007;104:416-21.
  • 19 Yun J, Kim SJ, Won JH, Choi CW, Eom HS, Kim JS, et al. Clinical features and prognostic relevance of ovarian involvement in non-Hodgkin′s lymphoma: A consortium for improving survival of lymphoma (CISL) report. Leuk Res 2010;34:1175-9.
  • 20 Peñalver FJ, Alvarez-Larrán A, Díez-Martin JL, Gallur L, Jarque I, Caballero D, et al. Rituximab is an effective and safe therapeutic alternative in adults with refractory and severe autoimmune hemolytic anemia. Ann Hematol 2010;89:1073-80.
  • 21 Kaufman M, Limaye SA, Driscoll N, Johnson C, Caramanica A, Lebowicz Y, et al. A combination of rituximab, cyclophosphamide and dexamethasone effectively treats immune cytopenias of chronic lymphocytic leukemia. Leuk Lymphoma 2009;50:892-9.
  • 22 Gupta V, Shukla J, Bhatia BD. Autoimmune hemolytic anemia. Indian J Pediatr 2008;75:451-4.