Primary Breast Lymphoma: Case Report Of A Rare Pathological Entity
Article Main Content
Primary breast lymphoma is a rare disease, which accounts for 0.4% of all malignancies seen in the breast and 2% of extranodal lymphomas. The majority of cases are B-cell lymphomas, with diffuse large cell (B) lymphoma the predominant histological type. A variety of treatment modalities have been suggested, with radiation therapy recommended for stage I patients and chemotherapy recommended for stage II patients. Outcome following treatment is predicted by the pathological grade of the tumor and the presence of lymph node involvement. Radical surgical resection including mastectomy has not been shown to affect the outcome of this entity.
A 61-year-old woman presented with a one month history of a painful right breast lump. Examination identified the presence of two lumps which were biopsied, confirming the presence of a lymphocytic lymphoma expressing a B-cell phenotype with co-expression of CD 43 (MT-1) consistent with MALT-type lymphoma.
She underwent further excision for recurrent tumor but declined adjuvant therapy. She has remained disease free during a 7-year follow up period.
Primary breast lymphoma is a rare malignancy of the breast representing less than 2% of non-Hodgkin lymphoma. The features on clinical breast examination and imaging are not characteristic and cannot be differentiated from breast carcinoma. Treatment involves surgical resection with adjuvant chemotherapy and radiotherapy administered in selected cases.
A 61-year-old woman presented with a one month history of a painful right breast lump. Examination identified the presence of two lumps which were biopsied, confirming the presence of a lymphocytic lymphoma expressing a B-cell phenotype with co-expression of CD 43 (MT-1) consistent with MALT-type lymphoma.
She underwent further excision for recurrent tumor but declined adjuvant therapy. She has remained disease free during a 7-year follow up period.
Primary breast lymphoma is a rare malignancy of the breast representing less than 2% of non-Hodgkin lymphoma. The features on clinical breast examination and imaging are not characteristic and cannot be differentiated from breast carcinoma. Treatment involves surgical resection with adjuvant chemotherapy and radiotherapy administered in selected cases.
References
-
Topalovski M, Crisan D, Mattson JC. Lymphoma of the breast. A clinicopathologic study of primary and secondary cases. Arch Pathol Lab Med. 1999 Dec;123(12):1208-1
DOI |
Google Scholar
1
-
Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer. 1972 Jun;29(6):1705-12.
DOI |
Google Scholar
2
-
Ferguson DJ. Intraepithelial lymphocytes and macrophages in the normal breast.Virchows Arch A Pathol Anat Histopathol. 1985;407(4):369-78.
DOI |
Google Scholar
3
-
Kim SH, Ezekiel MP, Kim RY. Primary lymphoma of the breast: breast mass as an initial symptom. Am J Clin Oncol. 1999 Aug;22(4):381-3.
DOI |
Google Scholar
4
-
Gholam D, Bibeau F, ElWeshi A, Bosq J, Ribrag V.Primary breast lymphoma. Leuk Lymphoma.2003;44(7):1173-1178.
DOI |
Google Scholar
5
-
Jennings WC, Baker RS, Murray SS, Howard CA, Parker DE, Peabody LF, Vice HM,Sheehan WW, Broughan TA. Primary breast lymphoma: the role of mastectomy and the importance of lymph node status. Ann Surg. 2007 May;245(5):784-9
DOI |
Google Scholar
6
-
Vardar E, Ozkok G, Cetinel M, Postaci H. Primary breast lymphoma cytologic diagnosis. Arch Pathol Lab Med. 2005 May;129(5):694-6
DOI |
Google Scholar
7
-
Domchek SM, Hecht JL, Fleming MD, Pinkus GS, Canellos GP. Lymphomas of the breast: primary and secondary involvement. Cancer. 2002 Jan 1;94(1):6-13.
DOI |
Google Scholar
8
-
Sabaté JM, Gómez A, Torrubia S, Camins A, Roson N, De Las Heras P, Villalba-Nuño V. Lymphoma of the breast: clinical and radiologic features with pathologic correlation in 28 patients. Breast J. 2002 Sep-Oct;8(5):294-304.
DOI |
Google Scholar
9
-
Mavromatis BH, Cheson BD. Pre- and post-treatment evaluation of non-Hodgkin's lymphoma. Best Pract Res Clin Haematol. 2002 Sep;15(3):429-47.
DOI |
Google Scholar
10
-
Dao AH, Adkins RB Jr, Glick AD. Malignant lymphoma of the breast: a review of 13 cases.Am Surg.1992 Dec;58(12):792-6.
Google Scholar
11
-
Babovic N, Jelic S, Jovanovic V. Primary non-Hodgkin lymphoma of the breast. Is it possible to avoid mastectomy? J Exp Clin Cancer Res. 2000 Jun;19(2):149-54.
Google Scholar
12
-
Uesato M, Miyazawa Y, Gunji Y, Ochiai T. Primary non-Hodgkin's lymphoma of the breast: report of a case with special reference to 380 cases in the Japanese literature. Breast Cancer. 2005;12(2):154-8. Review.
DOI |
Google Scholar
13
-
Radkani P, Joshi D, Paramo JC, Mesko TW. Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg.2014 Jan;149(1):91-3. doi: 10.1001/jamasurg.2013.2283.
DOI |
Google Scholar
14
-
Jeanneret-Sozzi W, Taghian A, Epelbaum R, Poortmans P, Zwahlen D, Amsler B, Villette S, Belkacémi Y, Nguyen T, Scalliet P, Maingon P, Gutiérrez C, Gastelblum P, Krengli M, Raad RA, Ozsahin M, Mirimanoff RO. Primary breast lymphoma: patient profile, outcome and prognostic factors. A multicentre Rare Cancer Network study. BMC Cancer. 2008 Apr 1;8:86. doi: 10.1186/1471-2407-8-86.
DOI |
Google Scholar
15
-
Miller TP, Dahlberg S, Cassady JR, Adelstein DJ, Spier CM, Grogan TM, LeBlanc M, Carlin S, Chase E, Fisher RI. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med. 1998 Jul 2;339(1):21-6.
DOI |
Google Scholar
16
-
Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P,Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002 Jan 24;346(4):235-42.
DOI |
Google Scholar
17
-
Joks M, Myśliwiec K, Lewandowski K. Primary breast lymphoma - a review of the literature and report of three cases. Arch Med Sci. 2011 Feb;7(1):27-33.
DOI |
Google Scholar
18
-
Avilés A, Delgado S, Nambo MJ, Neri N, Murillo E, Cleto S. Primary breast lymphoma: results of a controlled clinical trial. Oncology. 2005;69(3):256-60. Epub 2005 Sep 15.
DOI |
Google Scholar
19
Most read articles by the same author(s)
-
MICHAEL MCFARLANE,
Artificial Intelligence: The New Frontier in Surgery , European Journal of Medical and Health Sciences: Vol. 2 No. 4 (2020)