Primary Breast Lymphoma in a Woman: A Case Report and Review of the Literature

Abstract

Patient: Female, 43Final Diagnosis: Primary breast lymphomaSymptoms: —Medication: —Clinical Procedure: CT scan • PET • chemotherapy • radiotherapySpecialty: OncologyObjective:Rare diseaseBackground:Primary breast lymphoma (PBL) is an unusual clinical entity accounting for 0.4–0.5% of all breast neoplasms. The usual presentation includes a painless palpable mass similar to that of breast carcinoma. Diffuse large B-cell lymphoma (DLBCL) is the most common identifiable type of PBL based on the histopathological examination.Case Report:We report an unusual case of a 43-year-old Indonesian woman who presented with a 7-month history of a painless mass in the left breast. A core needle biopsy revealed diffuse infiltration of large atypical lymphoid cells. The immunohistochemical biomarkers confirmed the diagnosis of a DLBCL. A bone scan showed no evidence of bone metastasis. It was treated non-surgically, based on the decision of the breast multidisciplinary team (MDT). The patient was treated with 4 cycles of combination chemotherapy with R-CODOX/IVAC. A follow-up PET scan revealed non-significant mild F-18 fluorodeoxyglucose (FDG) uptake at the periphery of the residual left breast mass, indicating a radiologically favorable response.Conclusions:Early and accurate diagnosis of PBL is crucial for selecting the appropriate MDT treatment strategies to avert potentially harmful surgical interventions.

Diagnosis and management of breast lymphoma: a single-institution retrospective analysis

“…Breast lymphoma (BL) is a rare form of extranodal lymphoma (ENL) (1). It accounts for 1.7-2.2% of ENL (2) and represents 0.4-0.5% of breast malignancies (3)(4)(5)(6)(7), while being overall the most common extramammary cancer involving the breast (8,9). BLs have been categorized into primary breast lymphoma (PBL) and secondary breast lymphoma (SBL) types (10).…”

Primary Bilateral Malignant Non-Hodgkin’s Lymphoma of the Breast: A Case Report and Review of the Literature

“…Mastectomy is not the primary choice of treatment of PBL and the role of surgery should be limited to a biopsy to establish the correct histological diagnosis, leaving the curative treatment to radiotherapy and chemotherapy [13]. In the case we are reporting, the patient had undergone a mastectomy due to the rapid and aggressive course of the disease and the secondary infection under chemotherapy.…”

Secondary Breast Lymphoma: A Case Report

“…Due to its rare occurrence, only few studies on radiological fi ndings have been published, unanimously reporting radiologic features as non-pathognomonic [2,8,12,10]. Nevertheless, radiological work-up is usually the foundation on the way to diagnosis using mammography, ultrasound and MRI of the breast [5].…”

“…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].…”

“…invasive cancer or metastases) and a lymphoma affecting the breast is essential for treatment [4]. In B-cell lymphoma the therapy of choice consists of rituximab combined with an anthracycline-based CHOP (cyclophosohamide, doxorubicin, vincristine, prednisone) chemotherapy (and frequently additional radiation therapy) [1,13], moreover, excision -as opposed to breast cancer -is not recommended [4,5,14].…”