Diagnosis and Therapy of Malignant Lymphoma during Pregnancy

Abstract

Eighteen cases of malignant lymphoma associated with pregnancy observed at the National Cancer Institute of Milan from 1953 to 1968, are reported. Four patients without retroperitoneal adenopathies were treated prophilactically with endolymphatic radiotherapy (Lipiodol Fluide 181I) and became pregnant afterwards. Their pregnancy had a normal outcome. Two patients treated respectively during the first 4 months and from the 6th to the 7th month of pregnancy with antiproliferative agents (chlorambucil, vinblastine) delivered a normal infant while a third patient treated during the third month of pregnancy had a miscarriage. Two patients were treated with radiotherapy on adenopathies above the diaphragm and had normal pregnancy and delivery, with normal foetuses. The importance of diagnostic lymphography during pregnancy to define the stage of the disease and to plan the appropriate treatment is stressed. A therapeutic abortion is indicated only in presence of adenopathies below the diaphragm or in case of visceral involvement, discovered during the first three months of pregnancy. It was performed in one case after a lymphographic diagnosis of pelvic involvement.