Palatine Tonsil Diffuse Large B-Cell Lymphoma and Pregnancy: Case Report

Diffuse large B-cell lymphoma is the most common and aggressive subtype of B-cell non-Hodgkin lymphoma, and its occurrence during pregnancy or the postpartum period is rare. Management in this setting is challenging, due to risks to the mother and infant. We herein report the case of a 37-year-old woman diagnosed with diffuse large B-cell lymphoma of the palatine tonsil during the first postpartum week following a twin pregnancy. The disease was staged as IIBE, with nodal and extranodal involvement. Treatment consisted of six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, combined with prophylactic intrathecal methotrexate, cytarabine, and dexamethasone. Chemotherapy required early cessation of breastfeeding to ensure maternal safety and prevent neonatal exposure to cytotoxic agents. A complete metabolic response was confirmed by 18F-fluorodeoxyglucose positron-emission tomography. At 60 months of follow-up, the patient remains disease-free. This case highlights the therapeutic challenges of managing aggressive lymphomas in the postpartum setting.