Gelb A B, van de Rijn M, Warnke R A, Kamel O W
Department of Pathology, University of California, San Francisco 94143-0102, USA.
Cancer. 1996 Jul 15;78(2):304-10. doi: 10.1002/(SICI)1097-0142(19960715)78:2<304::AID-CNCR18>3.0.CO;2-#.
The natural histories of Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NHL) during pregnancy are not well understood.
All cases of HD and NHL diagnosed during pregnancy at Stanford University Medical Center since 1987 were reviewed and clinical follow-up was obtained. Various immunohistochemical studies and in situ hybridization for Epstein-Barr virus (EBV) encoded RNA were performed in a subset of cases.
Seventeen cases of HD and 12 cases of NHL were accessioned (median age; 27 yrs). The HD cases were classified as 13 nodular sclerosis type, 3 mixed cellularity type, and 1 unclassified. Clinical follow-up revealed most of the patients had Stage II to III disease and were diagnosed on average at 22 weeks gestation. Most of the patients deferred therapy until after delivery and had no evidence of disease at the last follow-up except for one death with disease but not from it. NHL were classified according to the working formulation as high or intermediate grade lymphomas of various types, including both nodal and extranodal sites. Clinical follow-up revealed most had Stage II to IV disease and were diagnosed on average at 23 weeks gestation. Patients with HD tended to survive longer than those with NHL (raw mortality, P = 0.04). In situ hybridization failed to provide support for the presence of EBV in a subset of patients with NHL.
The clinical behavior of these neoplasms during pregnancy does not appear to be significantly different from that outside of the setting of pregnancy. Treatment of selected HD patients apparently may be safely deferred until after delivery. Patients with NHL present with higher stage disease and have a poorer prognosis than those with HD.
孕期霍奇金淋巴瘤（HD）和非霍奇金淋巴瘤（NHL）的自然病程尚未完全明确。
回顾了1987年以来斯坦福大学医学中心孕期诊断的所有HD和NHL病例，并进行了临床随访。对部分病例进行了各种免疫组化研究以及针对爱泼斯坦-巴尔病毒（EBV）编码RNA的原位杂交。
共收录17例HD和12例NHL病例（中位年龄27岁）。HD病例中，13例为结节硬化型，3例为混合细胞型，1例未分类。临床随访显示，大多数患者为Ⅱ至Ⅲ期疾病，平均在妊娠22周时确诊。大多数患者推迟治疗至分娩后，除1例因疾病死亡外，末次随访时均无疾病证据。NHL根据工作分类法分为各种类型的高级别或中级别淋巴瘤，包括淋巴结和结外部位。临床随访显示，大多数患者为Ⅱ至Ⅳ期疾病，平均在妊娠23周时确诊。HD患者的生存期往往比NHL患者长（粗死亡率，P = 0.04）。原位杂交未能支持在部分NHL患者中存在EBV。
这些肿瘤在孕期的临床行为似乎与非孕期无显著差异。部分HD患者的治疗显然可安全推迟至分娩后。NHL患者疾病分期较高，预后比HD患者差。
