A rare case report of pregnant women with Hodgkins lymphoma

ABSTRACT Introduction: The simultaneous occurrence of cancer and pregnancy is an uncommon medical scenario and can pose a diagnostic and treatment challenge. Of malignancies diagnosed during pregnancy, hematologic malignancies rank second in the most prevalent neoplasms, after breast cancer, with Hodgkins Lymphomas (HL) and Non-Hodgkins Lymphomas (NHL) comprising nearly 6% and 5%, respectively. Case Presentation: A 28-year-old- female, Primigravidae with 39 weeks of gestational age with Hodgkins Lymphoma came to antenatal OPD at Government Maternity Hospital, Tirupati for regular antenatal checkups. Initially, in 2012, she had a history of neck swelling. On biopsy, it was diagnosed as tubercular lymphadenitis. However, because of poor patient compliance, she discontinued the treatment. Later on, the swelling gradually increased in size. On biopsy, it was diagnosed as Hodgkins Lymphoma. She had taken 16 cycles of chemotherapy with an ABVD (doxorubicin hydrochloride (Adriamycin), bleomycin sulfate, vinblastine sulfate, and dacarbazine) regimen. Radiological examination was performed with an Ultrasound neck revealed necrotic lymph nodes in bilateral level-V. Conclusion: Lymphoma is a rare diagnosis in pregnancy. Immunohistochemical markers provide prognostic stratification, and together with other clinical factors can outline the risk profile for certain groups of patients more accurately. Therefore, immunohistochemical evaluations should be considered in all cases. Key messages : Immunohistochemical markers provide prognostic stratification, and together with other clinical factors can outline the risk profile for certain groups. Studies suggest that HL in pregnancy shows promising results with ABVD as a regimen of choice if multi-agent chemo is required. A broad multidisciplinary team-based approach is vital for improved patient outcomes.