PMC6344925_01
Transvaginal ultrasound with inhomogenous mass in the right part of the small pelvis.
rjy367f01.jpg
PMC6344925_01_rjy367f01.jpg
rjy367F1
First seen by gynecologists, endovaginal ultrasound showed a solid tumor measuring 10x5x6.5 cm3, with inhomogeneous structure, suspicious of ovarian tumor (Fig. 1).
Thickened appendix and mesoappendix with porcelain-like suface.
rjy367f02.jpg
PMC6344925_01_rjy367f02.jpg
rjy367F2
The diagnostic laparoscopy revealed a strongly thickened and hardened vermiform appendix with a slightly porcelain-like surface and the appendiceal basis was involved (Fig. 2).
Peritoneal nodules seen in diagnostic laparoscopy.
rjy367f03.jpg
PMC6344925_01_rjy367f03.jpg
rjy367F3
In addition, massive mesenterial and retroperitoneal lymphadenopathy as well as peritoneal nodules especially in the small pelvis and right lower abdomen were detected (Fig. 3).
Magnification 10x, hematoxylin and eosin staining shows a monomorphic lymphoid population with a diffuse growth pattern.
rjy367f04.jpg
PMC6344925_01_rjy367f04.jpg
rjy367F4
MIB-1 was up to 75% (Figs 4 and 5).
Magnification 40x, the immunohistochemical staining shows strong diffuse nuclear expression of Cyclin D1 (>95% of all mantle cell lymphoma including CD5-negative cases).
rjy367f05.jpg
PMC6344925_01_rjy367f05.jpg
rjy367F5
MIB-1 was up to 75% (Figs 4 and 5).