Diffuse Large B Cell Lymphoma in a Male Breast - A Rare Case Report

Abstract

RezumatLimfomul difuz cu celulă mare B mamar la bărbaţi reprezintă o entitate rară ce poate mima carcinomul mamar ca prezentare clinică, de aceea tratamentul iniţial pentru majoritatea pacienţilor rămâne cel chirurgical. Diagnosticul şi tratamentul precoce complementar, chimioterapia şi radioterapia, sunt foarte importante. Vom prezenta cazul unui bărbat de 56 ani diagnosticat cu limfom difuz cu celulă mare B, primitiv cu localizare mamară -formaţiune tumorală mamară fără limfadenopatie axilară. În urma biopsiei mamare, examenul histopatologic susţinut de testele imunohistochimice stabilesc diagnosticul de limfom difuz cu celula mare B mare primitiv cu pozitivitate pentru CD 20, CD 10, şi negativitate pentru BCL 2, myc şi BCL 6 cu index de proliferare foarte mare (Ki 67 90%). Pacientul a primit trei cure de chimioterapie R-CHOP (rituximab, ciclofosfamida, adriamicina, vincristine si prednisolon). Limfomul difuz cu celulă mare primitiv mamar la bărbat reprezintă o entitate foarte rară, fiind necesară o supiciune ridicată pentru diagnosticul şi tratamentul precoce.Cuvinte cheie: limfom difuz cu celule mare B, sân, bărbat, tratament

Double-hit lymphoma of the male breast: a case report

“…In the few reported male cases, like in the patient presented here, breast lymphoma mainly affected men in the middle-to-old age groups [2][3][4][5][6][7][8]. Being initially considered as Burkitt lymphoma, we here rendered the diagnosis of a so-called "high-grade B-cell lymphoma with MYC and BCL2 rearrangements" also called "double-hit lymphoma" with Burkitt morphology.…”

“…To date, less than 50 cases of male breast lymphoma have been reported in the literature [1,2]. Clinical presentation of breast lymphoma in men usually resembles the more common carcinomas with a mammographically solitary well-circumscribed painless mass in the breast and/or the ipsilateral axillary lymph nodes commonly unilateral [3][4][5][6][7][8]. Previous reports on male breast lymphomas focused mainly on the clinical and pathological features of the tumor [3][4][5][6][7][8][9].…”

Primary breast lymphoma in males: Incidence, demographics, prognostic factors, survival, and comparisons with females

“…Wiseman and Liao confirmed the definition of PBL in 1972, including the following criteria: (1) sufficient tumor tissue for histological examination; (2) no previous lymphoid malignancy at regions outside the breast; (3) lymphoma primarily presented within breast regions; and (4) close associations between lymphoma and breast tissue (5). This infrequent tumor was found especially in females, and quite uniquely, there were a few case reports in males in previous literature studies (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Due to the extreme rarity and unspecific manifestations, male patients with PBL are easily misdiagnosed clinically, thus delaying the optimal treatment time window and causing great pain to patients during the period of seeking medical advice.…”

“…The standard treatment for male PBL remains unclear, and most of the reported cases were referred to the management for female patients ( 6 – 8 , 10 – 20 , 22 , 23 , 26 ). Our results demonstrated that chemotherapy and surgery did not significantly improve the survival outcome of male patients.…”

Primary breast lymphoma (PBL) in men — a systematic review

“…Interestingly in the present review, all eight male patients who received radiotherapy combined with other treatment modality were alive without evidence of disease after a median of 17 months [10,[24][25][26][27][28]. Four patients received higher than 30 Gy (they mostly received 50 Gy), and information about radiation dosage was not available in one patient [24].…”