Parvinder Singh

Primary ovarian diffuse large B-cell lymphoma

Primary ovarian lymphoma is a rare malignancy, representing <1% of ovarian neoplasms and a small subset of extranodal lymphomas, with diffuse large B-cell lymphoma (DLBCL) being the most frequent subtype. Diagnosis is often delayed because symptoms overlap with more common gynaecological or infectious conditions. We report a woman in her 20s presenting with hoarseness, exertional dyspnoea and low-grade fever. Imaging showed mediastinal lymphadenopathy, and repeated biopsies revealed necrotising granulomatous inflammation without malignancy. Persistent symptoms prompted fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT, which detected a hypermetabolic right adnexal mass; MRI suggested a high-grade neoplasm, and tumour markers were normal. Laparoscopic biopsy confirmed high-grade DLBCL (stage IV, germinal-centre B-cell subtype) with a high Ki-67 index. We report a woman in her 20s presenting with hoarseness, exertional dyspnoea and low-grade fever. Imaging showed mediastinal lymphadenopathy, and repeated biopsies revealed necrotising granulomatous inflammation without malignancy. Persistent symptoms prompted FDG PET-CT, which detected a hypermetabolic right adnexal mass; MRI suggested a high-grade neoplasm, and tumour markers were normal. Laparoscopic biopsy confirmed high-grade DLBCL (stage IV, germinal-centre B-cell subtype) with a high Ki-67 index.