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Lymphoma in Pregnancy Initially Diagnosed as Vaginal Intraepithelial Neoplasia and Lichen Planus

Nguyen, Thuong-Thuong MD, MS; Gubens, Matthew MD, MS; Arber, Daniel A. MD; Advani, Ranjana MD; Juretzka, Margrit MD, MS; Aziz, Natali MD, MS

doi: 10.1097/AOG.0b013e3182234d12
Case Reports
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BACKGROUND: Non-Hodgkin's lymphoma presenting as a vaginal mass in pregnancy is uncommon.

CASE: A 38-year-old primigravid woman presented at 27 weeks of gestation with vaginal lesions, bleeding, and discharge. Previous vaginal biopsies had been consistent with vaginal intraepithelial neoplasia 1 and lichen planus. After admission for this enlarging vaginal mass and bleeding, she was noted to have a newly palpable breast mass. Biopsy of the breast mass and subsequent re-evaluation of original vaginal biopsies were consistent with diffuse large B-cell lymphoma. She was treated with chemoimmunotherapy during pregnancy and delivered a viable neonate at term.

CONCLUSION: Although benign vaginal conditions are common, non-Hodgkin's lymphoma should be considered in the differential diagnosis of persistent or enlarging vaginal lesions in pregnancy.

Non-Hodgkin's lymphoma should be considered in the differential diagnosis of persistent or enlarging vaginal lesions in pregnancy.

From the Departments of Obstetrics and Gynecology; Medicine, Division of Oncology; and Pathology, Stanford University School of Medicine, Stanford, California; and Kaiser Permanente, Denver, Colorado.

The authors thank Florette Gray Hazard, MD, from the Department of Pathology at Stanford University School of Medicine for her contributions with the labeling of pathology figures in this case report.

Corresponding author: Natali Aziz, MD, MS, Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Room HH333, Stanford, CA 94305-5317; e-mail: naziz@stanford.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists