Stage IV Large B Cell Lymphoma Presenting as Gigantomastia and Pulmonary Hypertension

Abstract

This case demonstrates that systemic malignancies such as diffuse large B cell lymphoma should be considered in the differential diagnosis of gigantomastia during pregnancy. In addition, malignancy-related pulmonary hypertension during pregnancy may be reversible after chemotherapy, as reported in nonpregnant patients.

Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

“…Underlying malignancy presenting as bilateral gigantomastia was also reported by Vandenberghe and colleagues in 2005 [ 46 ], in which biopsy of the upper anterior mediastinum and bilateral breast tissue confirmed a diagnosis of T-cell lymphoblastic lymphoma [ 46 ]. Non-Hodgkin lymphoma was also reported by Sherer et al [ 47 ] in 2004, describing a woman presenting with breast swelling and bilateral axillary lymphadenopathy. Thorough workup is therefore required to either rule out malignancy or provide an early diagnosis so that patients are able to make informed decisions regarding their pregnancy before receiving treatment.…”

“Gestational Gigantomastia”: A Review Article and Case Presentation of a New Surgical Management Option

“…Gestational gigantomastia was the first clinical presentation of non-Hodgkin lymphoma in 3 cases. 13,39,45 Diagnosis of all these 3 cases was established only after delivery, and this delay in diagnosis, and in turn the delay in initiating chemotherapy, affected the prognosis of the disease greatly. Thus, with cases of gestational gigantomastia, clinicians should be careful to rule out any underlying malignancy.…”

Management of hematological malignancies during pregnancy

“…Presenting symptoms of NHL can be unusual during pregnancy leading to delays in diagnosis [78]. A high incidence of involvement of the breast [61,63,[79][80][81][82][83][84], uterus [55,85], cervix [86], and ovaries [65] by NHL has been reported during pregnancy. Involvement of the products of conception by malignancy is very rare; NHL has been reported to involve the products of gestation, including the fetus, in four cases, three of T-cell and one of B-cell subtype [87][88][89][90].…”