HOČKINOV LIMFOM U TRUDNOĆI: PRIKAZ SLUČAJA I PREGLED LITERATURE

Jelena Ivanović; Sofija Kozarac; Tamara Bibić; Vojin Vuković; Katarina Stefanović; Darko Antić

doi:10.5937/smclk5-52488

Jelena Ivanović Limfoma Centar, Klinika za hematologiju, Univerzitetski Klinički Centar Srbije
Sofija Kozarac Limfoma Centar, Klinika za hematologiju, Univerzitetski Klinički Centar Srbije, Beograd, Srbija
Tamara Bibić Limfoma Centar, Klinika za hematologiju, Univerzitetski Klinički Centar Srbije
Vojin Vuković Limfoma Centar, Klinika za hematologiju, Univerzitetski Klinički Centar Srbije
Katarina Stefanović Klinika za ginekologiju i akušerstvo, Univerzitetski Klinički Centar Srbije, Beograd
Darko Antić Limfoma Centar, Klinika za hematologiju, Univerzitetski Klinički Centar Srbije

DOI: https://doi.org/10.5937/smclk5-52488

Ključne reči: Hočkinov limfom, trudnoća, ABVD

Sažetak

Uvod/Cilj: Incidenca Hočkinovog limfoma (HL) je visoka u reproduktivnom periodu tako da problem javljanja ovog maligniteta tokom trudnoće predstavlja značajan problem u svakodnevnoj kliničkoj praksi. Cilj ovog rada je da se kroz prikaz slučaja prikaže karakteristični klinički tok i da se kroz pregled literature analiziraju do sada objavljeni podaci.

Prikaz slučaja: Trudnica, starosne dobi 33 godine, tokom trećeg trimestra trudnoće razvija otok vrata, noćno preznojavanje, svrab uz gubitak telesne mase. Ultrazvučnim pregledom otkrivena je značajna limfadenopatija u supraklavikularnoj regiji. Hirurška ekstirpacija limfnog čvora uz patohistološku verifikaciju potvrdila je dijagnozu Hočkinovog limfoma. S obzirom na trudnoću i ograničenu primenu radiografske dijagnostike, magnetna rezonanca (MR) je urađena i potvrdila je generalizovanu limfadenopatiju s posledičnom hidronefrozom desnog bubrega. Nakon postavljanja dijagnoze uznapredovalog stadijuma HL, odlučeno je da se započne specifično hematološko lečenje primenom citostatske terapije. Porođaj je sproveden u 37. nedelji gestacije prirodnim putem, bez komplikacija po majku i novorođenče. Nakon porođaja, sprovedena je kompletna reevaluacija bolesti, uz odluku da se lečenje nastavi do ukupno šest ciklusa hemioterapije prema ABVD (adriablastin, bleomicin, vinblastin, dakarbazin) protokolu. Nakon šest ciklusa hemioterapije, postignuta je metabolička remisija bolesti.

Zaključak: Lečenje Hočkinovog limfoma tokom trudnoće predstavlja kompleksan izazov koji zahteva koordinisan multidisciplinarni pristup i personalizovani plan lečenja.

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