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

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

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.

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.

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].

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.

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