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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

CASTILLO CRUZ, José Roberto et al. High-grade malignant B-Cell lymphoma with blastoid during pregnancy: a case report. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.9, pp.698-705.  Epub Nov 17, 2023. ISSN 0300-9041.  https://doi.org/10.24245/gom.v91i9.8036.

BACKGROUND:

Hodking's lymphoma is more common during pregnancy than non-Hodking's lymphoma; it affects, on average, women aged 30 years (18-44 years) and older. It is usually diagnosed around 28 weeks of pregnancy and is documented to be carried to term. Treatment regimens can be initiated in the immediate postpartum period or even earlier. The worldwide incidence of non-Hodking's lymphoma is 0.8 per 100,000 women; survival during pregnancy is unknown.

CLINICAL CASE:

34-year-old patient, with obstetric history of three pregnancies, one cesarean section and one abortion and the current pregnancy in progress at 29 weeks, referred from the city of Colima due to a report of BI-RADS 3 on breast ultrasound and a palpable breast nodule, with evidence of multiple tumors in the hepatic, splenic and peripancreatic area. Biopsy taken from the lesion areas reported: high grade malignant B-cell lymphoma, with blastoid morphology and expression of C-MYC and BCL2. In addition, the patient was found to have: anemia, abdominal pain, multiple hepatic nodules and abdominal adenopathies. It was decided to terminate the pregnancy at 30 weeks, with the delivery of an uncomplicated newborn. Rituximab-Etoposide, Prednisone, Vincristine, Cyclophosphamide, and Doxorubicin (R-EPOCH) therapy was started immediately with adequate adaptation by the patient.

CONCLUSION:

Since bibliographic information on lymphoma and pregnancy is scarce, the case reported here is relevant for its contribution. Multidisciplinary care will always favor the prognosis of patients.

Keywords : Pregnancy; Hodking’s lymphoma; non-Hodking’s lymphoma; B-cell lymphoma; biopsy; lymphadenopathy; anemia; Rituximab-Etoposide, Prednisone, Vincristine, Cyclophosphamide, and Doxorubicin (R-EPOCH) protocol.

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