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Spontaneous Regression In Non-hodgkin’s Lymphoma; Clinical And Pathogenetic Considerations

Drobyski & Qazi, 1989Lymphoma

American Journal of Hematology 1: 1989; 138-141

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Abstract

Cystic hygromas are congenital malformations of the lymphatic system that usually are located along the posterior surface of the neck. Prenatal sonographic detection of nuchal cystic hygromas generally is thought to carry a poor prognosis, and these lesions often are associated with chromosomal aneuploidies such as Turner syndrome. We report a case of spontaneous resolution of a prenatally detected cystic neck mass in a fetus with a normal karyotype and a normal outcome. This case demonstrates that in the absence of fetal hydrops, in utero detection of a nuchal cystic hygroma does not necessarily indicate an unfavorable prognosis, but occasionally can be associated with a normal clinical outcome.

Case Details

Clinical Characteristics

Indolent histologic subtypes, with a frequency of 10-20% in selected series

Remission Characteristics

Spontaneous regression

Treatment & Mechanisms

Proposed Remission Mechanisms

Contemporaneous bacterial or viral infection, augmented host immune response mediating tumor regression via humoral and cellular effector mechanisms, reduction of immunosuppression in cases of lymphomas developing after organ transplantation

Additional Notes

Indolent lymphomas which differ from aggressive lymphomas in their clinical and biological behavior may be more responsive to these host immunoregulatory influences. Review of clinical experience as well as proposed mechanisms of spontaneous regression in non-Hodgkin’s lymphoma are explored in this report.