| 【Background and aim of the study】Ovarian lymphoma is a rare solid mal-ignancy.Malignant lymphoma involving the ovary may be a primary extra nod-al disease,secondary involvement may be the initial manifestation of clinic al o-ccult lymphadenopathy,or may be a late complication of disseminated ly mph-oma.Primary extranodal lymphoma is less invasive,with a 5-year survival rate of 80% and a secondary lymphoma of 33%.Therefore,it is very import ant t-o distinguish them.Extranodal lymphoma refers to lymphoma that occurs outsi-de the lymph nodes.primary ovarian non-Hodgkin’s lymphoma(PONHL)is e-xtremely rare,accounting for only 0.5% of extranodal NHL and 1.5% of prim-ary ovarian malignancies.This article analyzes the clinical manifestations,diag-nosis and prognosis of 3 patients with primary ovarian non-Hodgkin’s lym pho-ma,and combines relevant literature and academic research at home and a broa-d to increase the clinician’s understanding of PONHL clinical features,im aging examination,immunohistochemistry results and treatment methods,thus i mprovi-ng the ability of clinicians to diagnose,differentially diagnose and clini cally tr-eat PONHL.【Method】 The clinical data of 3 patients with PONHL who were admit ted t-o the First Affiliated Hospital of Bengbu Medical College from January 2011 to October 2017 were collected.,and the related literatures in this field w ere r-eviewed.The path-ogenesis,diagnosis,treatment and prognosis of PONHL we-re discussed,and s-uggestions for the treatment of PONHL were put forw ard.【Results】Case 1 and case 2 were postmenopausal women,and case 3 w ere 19-year-old young patients.They were admitted to the hospital due to abdo men-al pain.Among them,case 1 performed comprehensive ovarian cancer sur gery,case 2 performed ovarian cancer cytoreductive surgery,and case 3 perfor med comprehensive ovarian cancer surgery by laparoscopic.The postoperative patho-logy was diffuse large B-cell lymphoma of the ovary.The postoperative immu-nohistochemistry results of case 1: CD20(3+),Pax-5(3+),mum-1(3+),Ki-67(3+,80%).After the operation,due to economic factors,intravenous che mothe-rapy with CHOP alone was given for 7 courses.One year after surgery,he w-as admitted to hospital again due to sudden blood in the stool.The pel vic ult-rasound showed a mixed mass in the left abdominal cavity.Considering the p-ossibility of tumor recurrence,he died during follow-up.The postoperati ve im-munohistochemistry results of case 2:CD20(+),Pax-5(+),mum-1(+),Ki-67(+,>70%),CD10(-).Treated by R-CHOP intravenous chemotherapy for8 cou-rses after surgery.Two year after the operation,due to "speech disorde r" in th-e outpatient examination of the head CT revealed brain metastases,the patient died during the follow-up.Case 3 postoperative immunohistochemistry results: CD20(3+),Pax-5(3+),mum-1(+),CD30(+),ALK-1(-),bcl-6(-),C D10(-),Ki-67(+,>90%).After the operation,the CHOP intravenous chemoth erapy w-as treated for 8 courses.Eight months after surgery,he was admitted to the h-ospital due to "abdominal wall mass " for biopsy.The pathology sugg ested m-alignant tumor.Considering the possibility of tumor recurrence,the RGDP in-travenous chemotherapy was given for 4 times.The abdominal wall m ass is n-ow significantly smaller than before,and the patient is still in the out patient f-ollow-up.【Conclusions】PONHL is a clinically rare malignant tumor.The diagnosi s of-ten depends on the comprehensive staging of ovarian cancer and the result s of immunohistochemical labeling.At present,the main treatment for its main treatment is ovarian cancer after comprehensive staged surgery,supplementedby r-adiotherapy and chemotherapy,chemotherapy is often CHOP,for CD20-po sitive lymphoma,can be added with rituximab,its prognosis is poor.For youn g pa-tients,wo could consider a treatment plan that preserves fertility.We can cryopreserve ovarian tissue before radiotherapy and chemotherapy.When the d isea-se is completely relieved,cryopreserved ovarian tissue can be re-implanted in t-he patient to restore ovarian function and spontaneous pregnancy. |
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