Dr Mehta’s Hospitals Successfully Treats Pregnant Women for Rare Blood Cancer ‘ Diffuse B cell lymphoma’
~ A huge mass of 195 sqcm on a critical position located between lungs, heart, and major blood vessels, compressing the windpipe of the patient ~
Chennai, August 4th , 2021: A 23-year-old female from Chennai, who is an expectant mother at 27 weeks of gestation presented with complaints of breathlessness and cough which has been progressively worsening over the period of the past 3 weeks to Dr. Jackin Moses R, Consultant Pulmonologist- Dr. Mehta’s Hospitals, Chennai. Her breathlessness had worsened to the point she was unable to lie down flat and unable to complete a full sentence. She has advised a CT chest with abdominal shielding to protect the baby from any damages of radiation, it revealed a large mass of 15cm X 13cm. The mass was seen in a space in the chest between the heart, lungs, and great vessels are known as the mediastinum. The patient was managed by a multidisciplinary team headed by Dr. Jackin Moses R, Consultant Pulmonologist, and Dr. Premalatha, Head of Department Obstetrics & Gynecology, at Dr. Mehta’s Hospitals.
The mass was finalized as an anterior mediastinal mass which required a biopsy for a clear diagnosis, CT guided biopsy was planned but we had to plan the difficult procedure with utmost care as the patient was unable to lie down, and similarly, we needed a good piece for optimal diagnosis. The procedure was done by the expert team at Dr. Mehta hospital with no complications to the mother and the fetus.
The biopsy revealed the tumor as Diffuse B Cell Lymphoma and the patient was sent for 4 cycles of palliative radiotherapy,, Post therapy the general condition of the patient improved and she was able to lie down flat and there was a significant reduction in her distress. Post radiotherapy the amniotic fluid was found to be critically low and thus the baby was delivered by cesarean section at 30weeks of pregnancy. Post-delivery the baby was managed in the NICU and is doing well now. The patient is currently undergoing chemotherapy and she is doing well with significant reduction in tumor size and good improvement in the general condition of the mother.
Breathlessness in pregnancy needs to be evaluated thoroughly, although the majority of which may be a part of normal pregnancy or commonly known conditions said Dr Jackin Moses R, Pulmonologist, Dr Mehta’s Hospitals. One needs to be mindful of rare instances due to cancerous growth in mediastinum which may be due to lymphoma, germ cell tumors, or thymoma. Though evaluation with biopsy gives a clear-cut diagnosis which enables us to effectively manage the woman, since management of each of the possibilities is by different approaches added Dr. Jackin Moses R
Mother is planned to receive 6 cycles of chemotherapy for further management of her cancer Which is safe to proceed with while nursing the child added Dr Jackin Moses