Abstract

Ovarian lymphoma (OL) is uncommon and its presentation is similar to more common ovarian cancers. Its treatment is different and can be conservative. Diagnosis of lymphoma requires histopathological evidence, but diagnostic imaging techniques such as ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance (MR) play a central role in the characterization of the lesion. This pictorial assay describes the radiological aspects of OL, to facilitate the Specialist to correctly orient diagnosis and avoid unnecessary adnexectomy. Ovarian involvement by malignant lymphoma occurs with a frequency of 7% to 26%, with up to 25% of women dying with lymphomas having ovarian infiltration at autopsy [1]. Involvement of the ovary in lymphomatous process can occur in two ways, either primary or secondary. Frequently, the ovarian mass is a manifestation of a widely disseminated lymphomatous disease, whereas the initial clinical manifestation of an occult lymphoma as an ovarian mass is uncommon [2, 3]. Primary OL is rare, accounting for only 0.5% of all Non Hodgkin Lymphoma (NHL), and 1.5% of all ovarian neoplasm [4]. Clinical presentation is non-specific (abdominal pain and distension), and physical examination may reveal a pelvic mass. Imaging techniques such as transvaginal sonography (TVS), CT and MR are usually performed in the work-up of women with abdominal complaint [2]. A proper differential diagnosis between OL and primary ovarian cancer is essential for treatment, because urgent chemotherapy is the optimal treatment for OL while surgical resection with debulking is the treatment of choice for the latter [3-7]. Our aim is to describe the radiological spectrum of appearances of OL reviewing literature and referring to our experience to illustrate aspects that, to our best knowledge, have not already been described. We wish that this pictorial assay will familiarize the specialist with US, CT and MR appearances of this condition, to correctly orient diagnosis