Primary and Secondary Breast Lymphoma: Clinical, Pathologic, and Multimodality Imaging Review

Abstract

Breast lymphoma is a rare hematologic neoplasm that originates in the breast lymphoid tissue and includes primary breast lymphoma (PBL) and secondary breast lymphoma (SBL). PBL involves the breast lymphoid tissue in the absence of previously identified extra mammary lymphoma and widespread disease. SBL is the most common metastasis to the breast, accounting for 17% of metastatic disease to the breast. PBL and SBL usually demonstrate imaging phenotypes that overlap with those of primary breast carcinoma, which makes a prospective diagnosis of breast lymphoma challeng ing. These nonspecific imaging features include an iso to hyper dense oval mass or masses at mammography, a hypoechoic or mixedechogenicity hypervascular mass at US, an enhancing mass with type II kinetics at MRI, and high fluorine 18-fluorodeoxyglu cose avidity at PET. In cases of suspected lymphoma, reviewing the clinical history, using appropriate biopsy techniques, and evaluating for multiplicity, bilaterality, and distant disease are critical for diag nosis and management. A patient with PBL generally has an earlier clinical presentation with a palpable abnormality and a solitary im aging finding. In contrast, multiple masses in an older patient and an occult clinical presentation favor an SBL diagnosis. ©

T‐cell non‐Hodgkin’s lymphoma of both breasts: An uncommon presentation of a common disease

“…3 The commonest histological subtype is diffuse large B-cell type (DLBCL), and the age of incidence is between 9 and 85 years with median age range between 55 and 65 years. 4,7 Our patient was 18 years old which is in the age range but with huge gap from median age. There was a delay of over a year in the establishment of the final diagnosis.…”

Clinical Characteristics and Outcomes of Primary Breast Lymphoma: The Cleveland Clinic Experience

“…The typical clinical presentation of PBL is with a solitary breast lump in female patients between 50 and 70 years of age [ 1 , 8 ]. Similarly, 39% of the patients presented with a breast lump, and the median age of the patients was 66 years in our study.…”

“…Mammographic features of PBL are distinct from invasive breast cancer. The role of breast ultrasound and magnetic resonance imaging in PBL diagnosis is not well established yet [ 7 - 8 , 13 ]. Retrospective studies reported no benefit of radical mastectomy compared to partial mastectomy or biopsy in terms of overall survival (OS) and progression-free survival (PFS) rates.…”

Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment

“…Although imaging studies in cases of breast lymphoma can suggest malignancy, they are not helpful in differentiating lymphoma from carcinoma. Therefore, accurate diagnosis is based on biopsy [19].…”