Hodgkin's lymphoma in pregnancy / Philippine Journal of Obstetrics and Gynecology

ABSTRACT

Lymphoma is the fourth most frequent malignancy diagnosed during pregnancy,occurring in approximately 16000 deliveries. In managing pregnant patients with Hodgkin's lymphoma, there are dilemmas to timely diagnosis and treatment, considering many of the diagnostic procedures and treatment options for the mother's condition may be harmful to the developing fetus. A 27-year-old G3P1 (1011) pregnant patient with a four-month history of anterior mediastinal mass, non-productive cough and low-grade afternoon fever, was initially treated as a case of community-acquired pneumonia. The patient was later admitted at our institution due to the persistence of symptoms, accompanied by dyspnea and chest pain. Biopsy done at 29 4/7 weeks age of gestational showed Hodgkins disease, lymphocyte depleted type (responsive to chemotherapy). At 31-32 weeks age of gestation, the patient started to experience dyspnea with intermittent low-grade fever. Chemotherapy consisting of doxorubicin 25mg/m2, bleomycin 10u/m2, vinblastine 6mg/m2 and dacarbazine 375mg/m2 was started. Radiotheraphy was deferred until after delivery. She underwent spontaneous vaginal delivery and delivered a live baby girl small for gestational age, with no congenital malformations. It is imperative that in pregnant patients presenting with anterior mediastinal masses, accompanied by systematic symptoms, timely histopathologic diagnosis through incision or excision biopsies should be obtained. Treatment options for these patients would differ based on the histology and stage of the disease and also the age of gestation of the pregnancy.???