A Rare Case of Bilateral Primary B-Cell Non-Hodgkin Lymphoma of Breast

Maharshi R Raval,Kishan G Patel,Kamal Sharma,Yash Patel,Suchi D Shah

doi:10.31579/2690-1897/080

Abstract

Primary B-Cell Non-Hodgkin Lymphoma of Breast is a rare presentation of breast malignancy and it is necessary to differentiate it from secondary breast lymphoma as prognosis and treatment varies based on the diagnosis. We report a case of 47-year-old female with bilateral PBNHL of Breast which is rare due to younger age of presentation than earlier reported cases of this malignancy, lump with “peau de orange” appearance seen in both the breasts which is usually seen with high grade lymphoma and complete recovery of the patient while bilateral PBL outlines poor prognosis. Mammosonography findings included dilated ducts with hypoechoiec areas. MRI showed altered signal intensity. Findings of the imaging studies are non-specific and vary widely from case to case which is why biopsy which is gold standard was done to confirm the diagnosis

Highlights

Primary B-Cell Non-Hodgkin Lymphoma of Breast is a rare presentation of breast malignancy and it is necessary to differentiate it from secondary breast lymphoma as prognosis and treatment varies based on the diagnosis
We report a case of 47-year-old female with bilateral Primary B-cell Non-Hodgkin Lymphoma (PBNHL) of Breast which is rare due to younger age of presentation than earlier reported cases of this malignancy, lump with “peau de orange” appearance seen in both the breasts which is usually seen with high grade lymphoma and complete recovery of the patient while bilateral primary breast lymphoma (PBL) outlines poor prognosis
secondary breast lymphoma (SBL) demonstrates a poor prognosis when compared with that of PBL and breast carcinoma. This case represents very rare and unusual early presentation of breast neoplasm in form of bilateral Primary B-cell Non-Hodgkin Lymphoma (PBNHL) of Breast, misdiagnosed initially as a granulomatous mastitis and required surgical biopsy which confirmed the diagnosis aided by immunohistochemical examination

Summary

Introduction

Breast lymphoma originates in the breast lymphoid tissue and includes primary breast lymphoma (PBL) which constitutes about 0.06% of breast malignancies, and secondary breast lymphoma (SBL) which constitutes about 0.12% of breast malignancies [1]. Palpation showed raised local temperature and tenderness present in whole breast with diffuse lump of approximately 10x10 cm sized involving whole breast with firm to hard consistency, fixed to the skin but not fixed to the chest wall. Left breast on inspection did not reveal any lump or redness or peau de orange appearance but on palpation approximately 5x6x2 cm sized lump was present in upper outer quadrant, well defined, firm to hard in consistency, mobile and not fixed to the skin and chest wall. Due to diagnostic uncertainty incisional biopsy on right side with excisional biopsy on left side was taken which showed bilateral breast involvement by follicular lymphoma with right axillary lymph nodes showing follicular lymphoma grade 2. Similar to the treatment of breast carcinoma, lumpectomy with radiation therapy is often performed in patients with low grade breast lymphoma. SBL demonstrates a poor prognosis when compared with that of PBL and breast carcinoma

Discussion

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Conclusion

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