Hodgkin's disease in pregnancy

H.A. is a 26-year-old gravida 1 para 0 who had an uncomplicated prenatal course until 18 weeks gestation when she began to experience unexplained night sweats and occasional fever. At her 20-week prenatal visit, a physical examination shown a 2 cm, firm, nontender, left posterior cervical lymph node. A surgical consult was obtained and subsequent biopsy of this lymph node showed nodular sclerosis Hodgkin's disease. A chest X-ray and single film lymphogram were negative. Laboratory tests including a complete blood count, liver function tests, and erythrocyte sedimentation rate were normal. After counseling by her obstetrician and a medical oncologist, it was decided to defer therapy until after delivery. The patient was without evidence of progression of her Hodgkin's disease for the remainder of her pregnancy. At 34 weeks gestation, the patient was induced and delivered a normal male infant weighing 2,400 g. Immediately postpartum, the patient received a course of localized supradiaphragmatic radiation therapy without complications. She has remained disease-free for 3 years following her treatment.