The signs and symptoms can be easily confused with symptoms associated to pregnancy.
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Although the lymph hodgkin cancer causes biopsy provides the certain diagnosis, all the other investigations must be performed. The treatment should be adjusted to each case. Astfel, managementul acestei patologii reprezintă o provocare, mai ales când afectează adolescente. Semnele şi simptomele pot fi cu uşurinţă confundate cu manifestări ale sarcinii.
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Deşi biopsia ganglionară furnizează diagnosticul de certitudine, este necesară o investigare paraclinică suplimentară.
Tratamentul trebuie ajustat fiecărui caz.
These abnormal lymphocytes — lymphoma cells — form tumors in lymph nodes or in other parts of the body like spleen, liver or bone marrow 1. HL is one of the most common lymphomas diagnosed during pregnancy, especially because the peak incidence of this disease coincides with female reproductive age 2.
HL hodgkin cancer causes diagnosed in hodgkin cancer causes to pregnancies 3. Depending on the histological subtype, the incidence of HL varies in different percentages all over the world: in developed countries it predominates the nodular sclerosis HL accounting in young adults; in economically disadvantaged areas it is more frequent a mixed cellularity HL accounting in children and older adults Pregnant patients with HL have the same signs and symptoms as non-pregnant patients with HL.
The particularity of the diagnosis in pregnancy resides in the fact that some signs and symptoms caused by HL fatigue, shortness of breath, anemia, thrombocytopenia overlap with common signs and symptoms seen during pregnancy, so it is very possible to omit the correct diagnosis from the beginning paraziți de viață de artă this can cause a delay of hodgkin cancer causes and precious time is lost A relatively common finding is eosinophilia that may be determined by the production of chemokines, such as interleukin-5 and eotaxin 8,11, Staging during pregnancy The initial staging evaluation of pregnant patients suspected for HL should include: History and physical examination.
Laboratory studies: complete blood count, erythrocyte sedimentation rate ESR, which is often significantly elevated during normal pregnancyserum creatinine concentration, serum liver enzymes, alkaline phosphatase and HIV serology. Evaluation of the intraabdominal disease with magnetic resonance imaging MRIcomputed tomography or ultrasound Bone marrow biopsy. During hodgkin cancer causes gallium scan, PET scan or bone scan are not indicated in order to establish the diagnose of HL The management of HL during pregnancy requires good communication between the haemato-oncologist, obstetrician, nurse specialists, midwives and neonatologists.
Although the goal of treatment should remain curative, there still exists some debate regarding the timing of chemotherapy, the curative nature of treatment and the timing of delivery She was gravida 1, para 1.
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The patient had insignificant personal pathological history. From her parents, we found out that she was the fourth child, with a normal somatic and neurologic development.
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She was vaccinated according to the National Program of Vaccination. She had a body mass index BMI of The hodgkin cancer causes began investigating her pregnancy at weeks of amenorrhea.
Until 19 weeks of pregnancy, there were no pathological problems, except for a chronic anemia, treated with oral iron. At weeks of pregnancy, the previous symptoms were aggravated and she presented to her physician with productive cough, dyspnea and bilateral cervical lymphadenopathy. At the pulmonary exam, bronchi rales were detected, therefore she was directed to the Emergency Room of the Emergency Clinical Hospital of Târgu-Mureş.
An ultrasound of soft tissue was performed, which indicated multiple lymphadenopathy — bilateral cervical, bilateral supraclavicular, between 5 mm and 4 cm. The blood samples indicated an important inflammatory syndrome, chronic anemia HGB 7.
An MRI was performed and revealed an adenopathyc mediastinal block with large vessels imbedded, with a mass effect on the trachea and esophagus and compressive effect on the superior vena cava and brachiocephalic trunks, confluent adenopathy mass retro and supraclavicular bilateral, axillary bilateral and middle and lower carotid-jugular.
A thoracic examination was performed which hodgkin cancer causes non-homogeneous pulmonary condensation in the right costo-diaphragmatic sinus without tumor imaging.
Also, the intradermal test for Koch bacillus BK was effectuated, and sputum examination for BK which was negative. During this hospitalization, the previous signs and symptoms were persistent. In addition, a thoracic examination was conducted and revealed a hodgkin cancer causes compression syndrome.
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A bone marrow cytology was performed — normal values were observed. Corticotherapy was initiated immediately: 8 mg of dexamethasone during the first day, 12 mg per day for the next 10 days, with progressive dose reduction. The initial evolution was clinically favorable, with diminishing adenopathy. The evolution was good for six days.
In the seventh day, the right cervical and supraclavicular adenopathy began to increase in size.