Abstract
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.
Highlights
Breast involvement by lymphoma can present as a primary breast tumor, or as an extranodal manifestation in systemic disease[4,5,6,7,8]
Breast plasmacytoma has been reported to occur in 1.5% of all incident plasmocytoma cases, whereas it accounts for only 0.2% of all malignant breast cancers[1]
Of the 78 cases with NHL, different B-cell lymphomas were identified in 75 patients (96.2%) and T-cell lymphoma in 3 patients (3.8%)
Summary
Breast involvement by lymphoma can present as a primary breast tumor, or as an extranodal manifestation in systemic disease[4,5,6,7,8]. There were reports of Hodgkin’s disease manifestation of the breast[15, 16]. At the moment, there is a paucity of studies focusing on radiological characteristics of different IHM. Various IHM imaging characteristics have been described in the literature, complicating radiological assessment of a crucial breast disorder[5, 9, 19, 20]. The purpose of our study was to assess radiological procedures and imaging characteristics of IHM in a large multicenter sample
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