Atsuko Yoshida, Takashi Kaji, Tatsuro Sugimoto, Ayuka Mineda, Shiroh Fujii and Takeshi Iwasa : Fatal Intratumoral Hemorrhage in Mediastinal Diffuse Large B-Cell Lymphoma During Pregnancy: A Case Report, The Journal of Obstetrics and Gynaecology Research, 52, 3, e70232, 2026.
(Summary)
We report a pregnant woman with diffuse large B-cell lymphoma (DLBCL) presenting as a massive mediastinal tumor causing dyspnea. A 34-year-old multiparous woman was diagnosed with the tumor at 16 weeks of gestation. During attempts at airway management using ECMO cannulation and intubation, she developed cardiopulmonary arrest due to airway compromise but was resuscitated. R-CHOP chemotherapy was initiated empirically, and subsequent biopsy confirmed DLBCL, leading to continuation of therapy using DA-EPOCH-R. Despite repeated discussions, including the option of pregnancy termination, the patient strongly wished to continue the pregnancy. Partial tumor shrinkage was achieved; however, at 24 weeks, she developed sudden massive hemoptysis and cardiopulmonary arrest, which proved fatal despite resuscitation. Postmortem imaging demonstrated tumoral hemorrhage with bronchial communication. Although tumoral hemorrhage is a rare complication of lymphoma, it should be recognized as a possible cause of sudden death in malignant disease. This case highlightsthe potential for catastrophic tumoral hemorrhage during chemotherapy and the complex ethical dilemmas surrounding pregnancy continuation.
Takeshi Iwasa, Hiroki Noguchi, Risa Tanano, Erika Yamanaka, Asuka Takeda, Kou Tamura, Hidenori Aoki, Tatsuro Sugimoto, Hikari Sasada, Takaaki Maeda, Saki Minato, Shota Yamamoto, Hiroaki Inui, Tomohiro Kagawa, Atsuko Yoshida, Ayuka Mineda, Mari Nii, Riyo Kinouchi, Kanako Yoshida, Yuri Yamamoto and Takashi Kaji : Age-Dependent Changes in the Effects of Androgens on Female Metabolic and Body Weight Regulation Systems in Humans and Laboratory Animals., International Journal of Molecular Sciences, 24, 23, 16567, 2023.
(Summary)
In recent years, the effects of androgens on metabolic and body weight regulation systems and their underlying mechanisms have been gradually revealed in females. In women and experimental animals of reproductive age, androgen excess can adversely affect metabolic functioning, appetite, and body weight regulation. In addition, excess androgens can increase the risk of metabolic disorders, such as obesity, insulin resistance, and diabetes. These unfavorable effects of androgens are induced by alterations in the actions of hypothalamic appetite-regulatory factors, reductions in energy expenditure, insulin resistance in skeletal muscle, and β-cell dysfunction. Interestingly, these unfavorable effects of androgens on metabolic and body-weight regulation systems are neither observed nor evident in ovariectomized animals and post-menopausal women, indicating that the adverse effects of androgens might be dependent on the estrogen milieu. Recent findings may provide novel sex- and age-specific strategies for treating metabolic diseases.