title: Lymphoma in pregnancy initially diagnosed as vaginal intraepithelial neoplasia and lichen planus.
abstract: BACKGROUND
  Non-Hodgkin's lymphoma presenting as a vaginal mass in pregnancy is uncommon.
  
  
  METHODS
  A 38-year-old primigravid woman presented at 27 weeks of gestation with vaginal lesions, bleeding, and discharge. Previous vaginal biopsies had been consistent with vaginal intraepithelial neoplasia 1 and lichen planus. After admission for this enlarging vaginal mass and bleeding, she was noted to have a newly palpable breast mass. Biopsy of the breast mass and subsequent re-evaluation of original vaginal biopsies were consistent with diffuse large B-cell lymphoma. She was treated with chemoimmunotherapy during pregnancy and delivered a viable neonate at term.
  
  
  CONCLUSIONS
  Although benign vaginal conditions are common, non-Hodgkin's lymphoma should be considered in the differential diagnosis of persistent or enlarging vaginal lesions in pregnancy.
authors.affiliation: From the Departments of Obstetrics and Gynecology; Medicine, Division of Oncology; and Pathology, Stanford University School of Medicine, Stanford, California; and Kaiser Permanente, Denver, Colorado.
authors.forename: Thuong-Thuong
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Matthew
authors.initials: M
authors.lastname: Gubens
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Arber
authors.forename: Ranjana
authors.initials: R
authors.lastname: Advani
authors.forename: Margrit
authors.initials: M
authors.lastname: Juretzka
authors.forename: Natali
authors.initials: N
authors.lastname: Aziz
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D036861:Delivery, Obstetric; D004317:Doxorubicin / Q000627:therapeutic use; D004598:Electrosurgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008010:Lichen Planus / Q000175:diagnosis*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014750:Vincristine / Q000627:therapeutic use; D002578:Uterine Cervical Dysplasia / Q000601:surgery
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone