Primary breast T cell lymphoma – a rare case report

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Primary breast lymphomas (PBL) are an exceptionally rare form of extranodal non-Hodgkin lymphoma (NHL), occurring in less than 0.5% of all breast malignancies.1 Primary breast T-cell lymphoma (TCL) is an even rarer entity, accounting for only 6% of breast lymphomas. It has an aggressive but poorly understood clinical course, and non-specific features that can mimic inflammatory breast carcinoma (oedema, skin changes and mastalgia).1 Currently, there is no standard treatment protocol for PBL, but a multimodal approach using diagnostic lumpectomy combined with chemotherapy and/or radiation therapy is recommended, versus radical mastectomy alone with no overall survival benefit and higher all-cause mortality rates.2 We present a case of a 64 year old female with a 12 month history of right breast pain with skin changes. Clinical and radiological examination (mammogram and ultrasound) revealed no focal lesion or lymphadenopathy. Multiple biopsies showed no evidence of malignancy. The patient was also treated with IV antibiotics with no improvement. Due to persistent symptoms and concern of inflammatory breast carcinoma, a mastectomy was performed. Haematoxylin and eosin (H&E) stained sections and molecular testing (immunohistochemistry and T cell gene rearrangement) confirmed primary breast T cell lymphoma.