Lymphoma Affecting the Breast: A Pictorial Review of Multimodal Imaging Findings

Abstract

Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.

Linfoma secundário da mama com apresentação clínica diferenciada

“…Achados ultrassonográficos típicos são tumores hipoecogênicos, ovais, circunscritos e microlobulados. Imagens de rotina, em geral não ajudam a diferenciar tumores primários de secundários 10,11 . O valor da ressonância magnética das mamas para avaliação de linfomas de mama ainda não está bem estabelecido.…”

“…O valor da ressonância magnética das mamas para avaliação de linfomas de mama ainda não está bem estabelecido. A combinação tomografia por emissão de pósitrons (PET-CT) é realizada para estadiamento inicial e para avaliar a recorrência da doença 11 . Hoje em dia ainda não existe tratamento padrão para o linfoma de mama, porque a raridade da doença dificulta a realização de estudos randomizados.…”

Secondary Breast Lymphoma: A Case Report

“…In case of PBL, the breast is the primary/only site of manifestation, whereas in SBL further manifestations of lymphoma are present [3], which has been reported as more common [2]. In general, breast lymphomas can be differentiated into B-cell (with 94% the most common type) and T-cell types (6%) [4], with the diffuse large B-cell lymphoma (DLBCL) representing the predominant entity with 40 -70% of all cases [5,6].…”

“…The most common clinical fi nding in B-cell lymphoma of the breast is a painless palpable mass, less frequently associated with retraction of the nipple [2,7,8]. Skin changes or edema, on the other hand, have been reported to occur more often in T-cell breast lymphoma [4,9]. Similarly, image fi ndings have been described as non-specifi c with a broad variety of features leaving an uncertainty to distinguish between breast carcinoma or hematological malignancy [2,4,7,8,[10][11][12].…”

“…Skin changes or edema, on the other hand, have been reported to occur more often in T-cell breast lymphoma [4,9]. Similarly, image fi ndings have been described as non-specifi c with a broad variety of features leaving an uncertainty to distinguish between breast carcinoma or hematological malignancy [2,4,7,8,[10][11][12]. Due to its rare occurrence and its non-specifi c fi ndings, these ambiguities can lead to misinterpretations of clinical and radiological features which may result in a delayed or inaccurate diagnosis.…”