Non-Hodgkin's lymphoma in pregnancy. Three cases and review of the literature.

The features of non-Hodgkin's lymphoma occurring in pregnancy were studied in three cases and reviewed in the 21 additional cases reported in the medical literature of the past 50 years. The inception and course of neoplasia in general appears to be affected by the hormonal and immune changes of pregnancy. Lymphomas occurring during this period are of high-grade malignancy and have a tendency to involve the organs most stimulated in pregnancy; breast, ovary, and uterus. The cell types are indicative of early stages of differentiation, and mediastinal location is more common. Despite the usually late diagnosis and the aggressive disease, the pregnancy can continue to term ending in the natural delivery of unaffected babies who remain healthy thereafter. The course of lymphoma, however, almost invariably accelerates post partum, particularly during lactation, resulting in the rapid deterioration and death of the mother. Results better than expected have been recently obtained with combination chemotherapy.