A Case of Maternal-Fetal Transmission of Diffuse Large B-cell Lymphoma

A neonate presented with rapidly enlarging congenital skin nodules, hepatomegaly and lymphadenopathy. A skin biopsy demonstrated dermal and subcutaneous soft tissue involvement by diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS) with an underlying IgH::BCL6 gene rearrangement and other pathogenic genetic lesions. Shortly after, the infant's mother presented with previously unrecognized bony lesions the biopsy of which revealed DLBCL, NOS with similar pathogenic genetic features. These findings are consistent with an exceedingly rare case of in utero maternal-to-fetal transmission of lymphoma. This case also illustrates the unique challenges of balancing intensive chemotherapy and toxicities in neonates and infants.