Lymphangiomas are congenital malformations of lymphatic vessels. More than 50% of these lesions are present at birth; 90% are diagnosed by the age of 2. These lesions do not expand very rapidly but they tend to infiltrate surrounding tissues; their degeneration into malignant tumors is an extremely rare occurrence. They are mostly located in the neck region and the axilla; breast lymphangioma is very rare. Surgery is usually performed for aesthetic reasons and in order to make a differential diagnosis with other, more common lesions. The surgical procedure involves the excision of the mass; other methods, such as radiotherapy and sclerotherapy, have proved to be completely ineffective.

An 82-year-old woman presented with a right breast lump with erythematous reaction of the overlying skin and corresponding lymph nodes. Cytological examination of the breast lesion and lymph nodes suggested a lymphoid proliferation. Frozen section revealed carcinoma with lymphoid stroma. Simple mastectomy was performed because of the extent of the lesion. Histological diagnosis was non-Hodgkin type B large-cell lymphoma. Primary breast lymphomas behave similarly to lymphomas of similar histologic types occurring in other sites. The authors illustrate the diagnostic difficulties and the usefulness of complementary techniques in the diagnosis of an unusual breast mass.