title: Diffuse large B-cell lymphoma occurring in an ovarian cystic teratoma: expanding the spectrum of large B-cell lymphoma associated with chronic inflammation.
abstract: Diffuse large B-cell lymphoma associated with chronic inflammation (DLBCL-CI) is a well-recognized entity, originally recorded as pyothorax-associated lymphoma because of the association with artificial pneumothorax. Clinically, it is characterized by a mass arising in a long-standing inflammation and by a poor prognosis. Recently, DLBCL-CI has been described growing along the wall of a preexisting cyst, without forming a mass. Here we describe a case of DLBCL-CI arising in the wall of a mature cystic teratoma of the ovary. On histology, the cystic surface of the cyst was infiltrated by large lymphocytes, immunoreacting with CD20, Multiple Myeloma Oncogene-1/Interferon Regulating Factor-4 (MUM1/IRF4), and PAX5 and positive for Epstein-Barr virus. "Cystic" DLBCL-CIs usually hold an indolent behavior despite heterogeneous therapeutic approaches. Some authors understandably wonder whether patients affected by "cystic" DLBCL-CIs are at risk for overtreatment, and, consequently, DLBCL-CIs associated with cystic lesions should be classified as an entity separated from classic pyothorax-associated lymphomas.
authors.affiliation: Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy 42123. Electronic address: valli.riccardo@asmn.re.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valli
authors.affiliation: Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy 42123.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Froio
authors.affiliation: Unit of Hematology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy 42123.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Alvarez de Celis
authors.affiliation: Unit of Gynecology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy 42123.
authors.forename: Vincenzo Dario
authors.initials: VD
authors.lastname: Mandato
authors.affiliation: Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy 42123.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Piana
mesh_terms: D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013724:Teratoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
keywords: Chronic inflammation; Diffuse large B-cell lymphoma; Mature cystic teratoma; Ovarian lymphoma; Ovary