ABSTRACTS OF THE 7^TH INTERNATIONAL CONFERENCE ON ADVANCES IN HEMATOLOGY AND ONCOLOGY (ICAHO2019)

摘要

Background: Breast cancer is one of the most common types of cancer among US women, accounting for 26% of all newly diagnosed cancer cases in women (1). Follicular lymphoma is a separate clinicopathological entity with tumor derived from germinal center B-cells. Concurrent existence of both types of cancer has been extremely rare with less than ten reported cases in literature (2). Case Report: A 71year-old Caucasian female, with history of invasive ductal carcinoma, status post bilateral mastectomy and completion of 5-year anastrozole therapy, presented for her annual Well Woman examination. An abnormally firm cervix was appreciated on pelvic examination. Subsequent transvaginal ultrasound revealed a thickened endometrium measuring 5.6 mm, as well as a solid left adnexal mass measuring 5.65.43.9 cm and the CA-125 level was mildly elevated at 51 U/ml. Computed tomography (CT) of the abdomen and pelvis further showed an enlarged left external iliac chain lymph node and increased density of the mesentery in the lower right quadrant. The patient underwent robotic total laparoscopic hysterectomy with bilateral salpingooophorectomy. Intraoperatively, a 5 cm solid mass was removed from the left ovary. The morphology and immunohistochemical staining patterns of the ovarian mass was consistent with a diagnosis of follicular lymphoma. Bone marrow biopsy was negative for malignancy but findings on positron-emission tomography/CT were concerning for disease involving cervical and external iliac nodes, left and right submandibular glands, and right parotid gland. The final diagnosis was stage IIIA, grade 3A/B follicular lymphoma. Conclusion: Follicular lymphoma is generally diagnosed at later stages with waxing and waning lymphadenopathy. Ovaries only comprise 0.5% of extranodal non-Hodgkin's lymphomas (3, 4). On the other hand, primary ovarian lymphomas account for 1.5% of all ovarian neoplasms (4). This atypical presentation of an asymptomatic primary ovarian non-Hodgkin's lymphoma emphasizes the importance of skilled physical examination in the primary care setting, which can help in the early diagnosis of various indolent diseases, including cancer.