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(a) CT scan showing swellings in the lymph nodes (arrows). (b) Low-density areas in the spleen were also observed (arrows), suggesting metastasis from a malignant tumor of the left ovary.
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The CT scan also revealed a > 10-mm lymph node swelling in the dorsal pancreas (Fig. 1a) and multiple low-density areas in the spleen (Fig. 1b).
(a) 18FDG avidity was observed in the lymph nodes (arrows) and (b) in the spleen (arrows).
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Following whole body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), elevated FDG uptake was reported in the left adnexa, in the lymph nodes along the iliac arteries, in the dorsal pancreas and spleen (Fig. 2a,b).
(a) Microscopic findings of the resected ovarian tumor and lymph nodes. Atypical cells with clear cytoplasm grew papillary, tubulocystic, and focally solid pattern (hematoxylin and eosin [HE]). (b) Non-caseating epithelioid granulomas were observed in the pelvic lymph node as well as in the spleen where there were no metastatic lesions (HE).
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Specifically, a distinct hobnail pattern was observed (Fig. 3a). Histopathological examination of the resected lymph nodes and spleen revealed a non-caseating epithelioid cell granuloma (Fig. 3b), wherein no tumor cells were identified.