Key result
A 32-year-old pregnant woman with cardiac tamponade revealing primary mediastinal large B-cell lymphoma experienced spectacular clinical improvement following pericardiocentesis and R-CHOP chemotherapy.
Why the study?
PMBCL rarely occurs during pregnancy, and cardiac tamponade is unusually found in pregnant women.
Case Report (n=1)
Primary mediastinal large B-cell lymphoma can rarely present as cardiac tamponade during pregnancy, which can be successfully managed with urgent pericardiocentesis and R-CHOP chemotherapy without adverse fetal outcomes.
Supports individualized management of rare tamponade presentations in pregnancy; leaves open need for prospective data on optimal regimens and outcomes.
Primary mediastinal large B-cell lymphoma (PMBCL) is a distinct entity within B-cell lymphomas (2-4% of non-Hodgkin lymphomas). It occurs most frequently in young females but rarely during pregnancy. Moreover, a cardiac tamponade is unusually found in pregnant women. We describe a case of a 32-year-old woman, 16-week pregnant, with cardiac tamponade revealing PMBCL, where urgent pericardiocentesis was required to maintain maternal cardiac function. An MRI (Magnetic Resonance Imaging) revealed a huge mediastinal mass of which biopsy confirmed the diagnosis of a PMBCL. A spectacular improvement of the clinical signs was obtained after a first line chemotherapy including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Our patient received the entire chemotherapy during her pregnancy with a regular multidisciplinary follow up. PMBCL can expose pregnant women to cardiac tamponade, and physicians should be aware of this complication mainly when pericardiocentesis is necessary.
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Badre et al. (2020) conducted a case report in Primary mediastinal large B-cell lymphoma with cardiac tamponade (n=1). Pericardiocentesis and R-CHOP chemotherapy was evaluated on Clinical improvement. A 32-year-old pregnant woman with cardiac tamponade revealing primary mediastinal large B-cell lymphoma experienced spectacular clinical improvement following pericardiocentesis and R-CHOP chemotherapy.
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