Ovarian lymphoma treatment

The ovaries are very important to female friends, and the lymph nodes are an important cotton clothing system in our body. Ovarian lymphoma affects the reproductive function of women, and over time it will cause various joint pains and vaginal discomfort to women. We need to understand the causes of ovarian lymphoma. It is very important to treat the disease accordingly to protect the health of our female friends.

Primary ovarian lymphoma

1. Concept

Primary ovarian lymphoma (POL) is very rare, accounting for 0.04% to 0.3% of all ovarian malignancies, and most cases are reported in individual case reports and retrospective summaries. According to domestic reports, POL accounts for 1.2% to 1.4% of extranodal lymphoma, while in Europe and the United States it only accounts for 0 to 0.3%. The number of reports of this disease has increased in recent years, which may be related to the further improvement of pathological diagnostic technology.

Most of the POL cases reported so far are non-Hodgkin's lymphoma, with diffuse large B-cell type being the most common, while reports of Hodgkin's lymphoma are rare. POL can occur unilaterally or bilaterally, with bilateral disease accounting for 48.2% to 52.4%, with the right side being more common than the left side. The disease is usually diagnosed in the middle or late stages, mainly in stages III and IV. POL is highly malignant and has a poor prognosis.

The disease is most common between the ages of 30 and 40, when women are at their peak childbearing age. It is speculated that the cause of the disease may be related to the vigorous ovarian function during this period, which makes it easy to get a viral infection, but the specific cause needs further study.

2. Clinical manifestations

Ovarian lymphoma often occurs before menopause. The clinical manifestations are nonspecific. There may be no symptoms in the early stages, and a pelvic mass may occasionally be palpated. In the later stages, symptoms such as abdominal distension, abdominal pain, ascites, irregular menstruation, vaginal bleeding, and amenorrhea often occur. Symptoms such as fever, weight loss, night sweats, bone and joint pain, and lower limb edema may also occur. Ovarian lymphomas are rarely asymptomatic and are discovered incidentally during a physical examination.

The vast majority of ovarian lymphomas are bilateral, and the lesions can range from the size of a normal ovary to a larger mass (up to 20 cm in diameter). POL may also involve the fallopian tubes, uterine serosa, omentum, mesentery, abdominal wall, pelvic wall, intestinal wall, appendix, para-aortic lymph nodes, and pelvic lymph nodes. In late stages, the tumor may affect the kidneys, pancreas, stomach and other organs.

Because of its low incidence and nonspecific clinical manifestations, this disease can be easily diagnosed as other types of ovarian malignant tumors.

Case reports have found that ovarian lymphoma can be combined with autoimmune hemolytic anemia, hypercalcemia, Meigsps syndrome, borderline serous sarcoma, ovarian adenocarcinoma, teratoma tumor lysis syndrome, etc.

3. Laboratory Examination

Complete blood count, white blood cell classification, platelet count, full set of metabolic index tests, LDH, ESR, β2 microglobulin, serum albumin, abdominal plain film or CT, abdominal B-ultrasound, pelvic B-ultrasound or CT, bone marrow biopsy or smear, ovarian pathological biopsy, immunophenotyping, paraffin section, flow cytometer analysis of cell surface markers, FISH test, etc.

POL often appears as a homogeneous parenchymal medium echo on B-ultrasound. CT scans show a relatively uniform mass that is round, clearly delineated or lobed, without obvious necrosis, hemorrhage or calcification, and relatively poor in blood supply. MRI shows solid bilateral masses. Ovarian lymphoma often presents as low signal on TWI, equal or slightly high signal on TWI, and mild to moderate enhancement after enhancement. Ferrozzi et al. believed that the ring-shaped enhancement at the edge of the mass may be the characteristic that distinguishes POL from other ovarian tumors on MRI.

4. Diagnosis and differential diagnosis

The clinical manifestations of primary ovarian lymphoma are very similar to those of other primary ovarian tumors, and preoperative diagnosis is very difficult. Its diagnosis requires surgical exploration and postoperative pathological examination results.

Robert's diagnostic criteria are:

① Meet the diagnostic criteria for primary extranodal lymphoma (excluding involvement of lymph nodes, blood, bone marrow, etc.);

② The tumor is confined to the ovary, or the ovary, ovarian draining lymph nodes, and ovarian adjacent structures are locally affected.

The most commonly used diagnostic criteria are those of Fox (1988):

① Clinically, the lesion is limited to the ovary, and no lymphoma is found in other parts;

② There should be no abnormal cells in peripheral blood and bone marrow;

③ If lymphoma occurs in tissues and organs far away from the ovaries, it should appear at least several months after the ovarian lesions;

④No history of lymphoma.

Timely diagnosis of ovarian lymphoma can promptly identify the symptoms of the disease, and we can also have an understanding of the condition of lymphoma. When diagnosing diseases on a daily basis, we need to cooperate with the doctor's treatment and have a light diet. Maintaining an optimistic attitude towards life can bring certain benefits to our treatment of diseases.