MEETING No. 44, - JULY 6th, 2002 AT THE
MANTUA HOSPITAL

Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 5


"OVARIAN MASSES"
G. DELL'ANTONIO - Humanitas Private Hospital - Rozzano
(pict. by dr. Dell'Antonio)

Clinical history: a 60y.o.woman with a past history of 2 pregnancies, presents with 10 days history of abdominal pain, epigastralgia and irregular motion.
Blood tests are normal. On US there are bilateral, 5 and 6 cm ovarian masses with a regular involuted uterus. An isterectomy with bilateral ovariectomy and omentectomy is performed.
Macroscopical description: numerous nodules are observed on the ovaries, the omentum and the uterine serosa.
Microscopical description: sections show a dense proliferation of monomorphic cells (pict. 1) with multinucleated, round nuclei and scanty cytoplasm (pict. 2); sometimes the infiltrating cells have an indian file appearance (pict. 3).
Mitoses and necroses are prominent.
With immunohistochemical staining the neoplastic cells are negative for the epithelial markers (CK7, for instance) (pict. 4), for Vimentin, PLAP and Synaptophysin; they are strongly positive for LCA (pict. 5), CD20 (pict. 6), CD10 (pict. 7) and they show diffuse nuclear positivity (more than 90%) for KI-67 (pict. 8).
The other lymphocite markers are negative (CD3, CD5, CD23, CD30, ALK, TdT and bcl-6).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8

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