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case_images: Transvaginal ultrasound with inhomogenous mass in the right part of the small pelvis.
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case_images: First seen by gynecologists, endovaginal ultrasound showed a solid tumor measuring 10x5x6.5 cm3, with inhomogeneous structure, suspicious of ovarian tumor (Fig. 1).
case_images: Thickened appendix and mesoappendix with porcelain-like suface.
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case_images: 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).
case_images: Peritoneal nodules seen in diagnostic laparoscopy.
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case_images: 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).
case_images: Magnification 10x, hematoxylin and eosin staining shows a monomorphic lymphoid population with a diffuse growth pattern.
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case_images: MIB-1 was up to 75% (Figs 4 and 5).
case_images: Magnification 40x, the immunohistochemical staining shows strong diffuse nuclear expression of Cyclin D1 (>95% of all mantle cell lymphoma including CD5-negative cases).
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case_images: MIB-1 was up to 75% (Figs 4 and 5).