To assess radiological procedures and imaging characteristics in patients with intramammary hematological malignancies (IHM). Radiological imaging studies of histopathological proven IHM cases from ten German University affiliated breast imaging centers from 1997-2012 were retrospectively evaluated. Imaging modalities included ultrasound (US), mammography and magnetic resonance imaging (MRI). Two radiologists blinded to the histopathological diagnoses independently assessed all imaging studies. Imaging studies of 101 patients with 204 intramammary lesions were included. Most patients were women (95%) with a median age of 64 years. IHM were classified as Non Hodgkin lymphoma (77.2%), plasmacytoma (11.9%), leukemia (9.9%), and Hodgkin lymphoma (1%). The mean lesion size was 15.8 ± 10.1 mm. Most IHM presented in mammography as lesions with comparable density to the surrounding tissue, and a round or irregular shape with indistinct margins. On US, most lesions were of irregular shape with complex echo pattern and indistinct margins. MRI shows lesions with irregular or spiculated margins and miscellaneous enhancement patterns. Using US or MRI, IHM were more frequently classified as BI-RADS 4 or 5 than using mammography (96.2% and 89.3% versus 75.3%). IHM can present with miscellaneous radiological patterns. Sensitivity for detection of IHM lesions was higher in US and MRI than in mammography.Intramammary hematological malignancies (IHM) have been described as a inhomogeneous group of breast malignancies, including various subtypes of malignant lymphomas, plasmacytomas and leukemias 1-3 . Overall, breast involvement in malignant hematological diseases is an uncommon manifestation and accounts for approximately 0.04-0.5% of all malignant breast cancers 4,5 . Of all extranodal malignant lymphomas, approximately 0.85-2.2% manifest as primary breast lymphomas 6-8 . Secondary breast involvement in a patient, who has a history of systemic malignant lymphoma, is more common [9][10][11] .Breast involvement by lymphoma can present as a primary breast tumor, or as an extranodal manifestation in systemic disease [4][5][6][7][8] .