Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.482
Peer-review started: September 11, 2020
First decision: November 14, 2020
Revised: November 16, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: January 16, 2021
Double-hit lymphoma is a highly aggressive B-cell lymphoma that is genetically characterized by rearrangements of MYC and BCL2 and/or BCL6. Lymphoma is often accompanied by atypical systemic symptoms similar to physiological changes during pregnancy and is often ignored. Herein, we describe a gravid patient with high-grade B-cell lymphoma with a MYC and BCL-2 gene rearrangement involving multiple parts of the body.
A 32-year-old female, gestational age 22+5 wk, complained of abdominal distension, chest tightness and limb weakness lasting approximately 4 wk, and ovarian tumors were found 14 d ago. Auxiliary examinations and a trimanual gynecologic examination suggested malignant ovarian tumor and frozen pelvis. Coupled with rapid progression, severe compression symptoms of hydrothorax, ascites and moderate anemia, labor was induced. Next, biopsy and imaging examinations showed high-grade B-cell lymphoma with a MYC and BCL-2 gene rearrangement involving multiple parts of the body. She was referred to the Department of Oncology and Hematology for chemotherapy. Because of multiple recurrences after complete remission, chemotherapy plans were continuously adjusted. At present, the patient remains in treatment and follow-up.
The early detection and accurate diagnosis of lymphoma during pregnancy can help expedite proper multidisciplinary treatment to delay disease progression and decrease the mortality rate.
Core Tip: To our knowledge, this is the first study to describe a patient with double-hit lymphoma during pregnancy. We should be well aware of the gynecological manifestations of lymphoma and consider it in the differential diagnosis of pelvic tumors. To avoid an unnecessary radical operation, biopsy should be considered instead of exploratory laparotomy in young women with suspected malignant tumors as well as acute onset, rapid progression and growing chylous pleural effusion containing abundant lymphocytes. The early detection and accurate diagnosis of lymphoma during pregnancy can help expedite proper multidisciplinary treatment to delay disease progression and decrease the mortality rate.