In the past two decades there has been an increase in the incidence of non-Hodgkin lymphoma and Hodgkin disease. This has been accompanied by an increase in the numbers of extranodal lymphoma. Despite this primary breast lymphoma is a rare disease. We present a case of a 74 year old female with primary breast lymphoma. Methods of imaging including PET/CT are discussed. Criteria for diagnosing primary breast lymphoma are presented. In addition diagnostic methods and therapeutic options are considered.