Primary ovarian diffuse large B-cell lymphoma preceded by autoimmune hemolytic anemia

A 62-year-old woman was diagnosed with autoimmune hemolytic anemia (AIHA), with cytology- and culture-negative pleural effusion. AIHA did not improve with steroid therapy. Computerized tomography (CT) detected a left ovarian tumor, which was resected surgically, and AIHA improved temporarily. Pathological examination yielded a diagnosis of diffuse large B-cell lymphoma (DLBCL). Positron emission tomography with CT suggested systemic infiltration of lymphoma. Rituximab-containing chemotherapy (R-CHOP regimen) yielded rapid decreases in lymphoma lesions and pleural effusion with improvement of AIHA. After six courses of R-CHOP, complete response (CR) was confirmed and AIHA remitted completely. Two months after confirmation of CR, however, lymphoma and AIHA relapsed simultaneously. To our knowledge, this is the first case report describing ovarian DLBCL preceded by AIHA.