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Case ReportOpen Access

Intrauterine Lymphoma in A Developing Community Volume 9- Issue 3

Wilson IB Onuigbo1* and Godwin Ugbam2

  • 1Departments of Pathology, University of Nigeria Teaching Hospital, Nigeria
  • 2Departments of Pediatrics, University of Nigeria Teaching Hospital, Nigeria

Received: September 24, 2018;   Published: September 27, 2018;

*Corresponding author: Wilson IB Onuigbo, Departments of Pathology University of Nigeria Teaching Hospital, Enugu 400001, Nigeria

DOI: 10.26717/BJSTR.2018.09.001794

Abstract PDF

Abstract

A combined group of doctors working in different hospitals speculated that Hodgkin's disease is initiated by two events in fetal life. On the whole, pregnancy related factors, such as intra-uterine infection and factors associated with preterm labor, may be involved in lymphoma pathogenesis. Therefore, a Nigerian case is deemed to be reportable because the lesions, which appeared at birth, continued till the age of 1 year when the diagnosis was confirmed following surgical biopsy.

Keywords: Pregnancy; Child birth; Lymphoma at birth; Case report

Introduction

In a population-based study of California birth Certificates [1], "intra-uterine infections and factors associated with preterm labor may be involved in lymphoma pathogenesis." Elsewhere, "in a large national cohort study, family history of NHL high fetal growth, older maternal age, low birth order, and male sex were independent risk factors for NHL, in early life" [2]. What of the individual case? This came to light among the Ibo ethnic group [3]. On account of the facility of establishing of a histopathology data pool, which was recommended by a Birmingham (UK) group [4], this was used by the senior author (WIBO) and his clinical colleague (GU) in the following case.

Case Report

MA, a 1-year-old girl, was brought to Dr G Ugbam in the pediatric clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. The mother's complaints were of the child's multiple, painless, firm swellings since birth. Examination confirmed the multiplicity of growths all over the body. Total excisions of 10 such lumps were carried out. Numerous nodular tissues, the largest 1.5 cm across, were submitted to the corresponding author. On microscopy, the cells were small and round with high mitotic activity and lymphoid look. Malignant lymphoma was diagnosed. There was no reported follow-up.

Discussion

The beauty of this case is the reality of the clinical story. But for the circumstance of occurring in a developing community, some records are missing such as answering one important question [5], namely, "Is birth weight associated with childhood lymphoma?" On the whole, the questions being researched elsewhere include

    (i) Season of birth [6],

    (ii) Birth characteristics [7],

    (iii) Maternal and perinatal characteristics [8], and

    (iv) What are called "maternal and birth anthropometric characteristics [9].

Conclusion

There is need for case reports on patients with odd lesions which turn out to be lymphomas. Broadly, a group working in USA, UK, Saudi Arabia, and Finland [10] singled out a particular lymphoma thus: We have shown that Hodgkin’s lymphoma is associated with prolonged gestation and a short length of the placental surface. We speculate that Hodgkin's lymphoma is initiated by two events in fetal life. One, which is an immune event, is associated with prolonged gestation, while the other is associated with growth faltering.

References

  1. Marcotte EL, Ritz B, Cockburn M, Clarke CA, Heck JE (2014) Birth characteristics and risk of lymphoma in young children. Cancer Epidemiol 38(1): 48-55.
  2. Crump C, Sundguist K, Sieh W, Winkleby MA, Sundquist J (2012) Perinatal and family risk factors for non-Hodgkin lymphoma in early life: A Swedish national cohort study. J Natl Cancer Inst 104(12): 923-930.
  3. Basden GT (1966) Niger Ibos. Cass, London, UK.
  4. Macartney JC, Rollaston TP, Codling BW (1980) Use of a histopathology data pool for epidemiological analysis. J Clin Pathol 33(4): 351-353.
  5. Papadopoulou C, Antonopoulos CN, Sergentanis TN, Panagopoulou P, Belechri M (2012) Is birth weight associated with childhood lymphoma? A meta-analysis. Int J Cancer 130(1): 179-189.
  6. Crump C, Sundquist J, Sieh W, Winkleby MA, Sundquist K (2014) Season of birth and risk of Hodgkin and non-Hodgkin lymphoma. Int J Cancer 135(11): 2735-2739.
  7. Marcotte EL, Ritz B, Cockburn M, Clarke CA, Heck JE (2013) Birth characteristics and risk of lymphoma in young children. Cancer Epidemiol 38(1): 48-55.
  8. Peckham Gregory EC, Danysh HE, Brown AL, Eckstein O, Grimes A (2017) Evaluation of maternal and perinatal characteristics on childhood lymphoma risk: A population-based case-control study. Pediatr Blood Cancer 64(5).
  9. Petridou ET, Sergentanis TN, Skalkidou A, Antonopoulos CN, Dessypris N (2015) Maternal and birth anthropometric characteristics in relation to the risk of childhood lymphomas: A Swedish nationwide cohort study. Eur J Cancer Prev 24(6): 535-541.
  10. Barker DJP, Osmond C, Thornburg KL, Kajantie E, Eriksson JG (2013) The intrauterine origins of Hodgkin's lymphoma. Cancer Epidemiol 37(3): 321-323.