Case Of Primary Breast Lymphoma Research Articles

About A Case: Primary Breast Lymphoma (Diffuse Large B cell Lymphoma)

Primary breast lymphoma is a rare neoplasia, with little clinical and imaging specificity. These are essentially type B lymphomas, of which the most common is diffuse lymphoma with large B cells. It is an entity that presents a prognostic impact from the outset by their localization but also by the risk of neurological relapse. The treatment of primary breast lymphoma depends on lymphomatous localizations and of course the histological type. There remain some questions to be raised regarding the place of radiotherapy in the treatment of certain localized histological forms, as well as the interest of systematic neuromeningeal prophylaxis in this breast localization. We report a case of primary breast lymphoma in a 50-year-old patient with no particular history.

Reports of primary and secondary breast lymphoma: our experience in King Chulalongkorn Memorial Hospital

We report four cases of primary breast lymphoma (PBL) and five cases of secondary breast lymphoma (SBL). We illustrate imaging findings in various imaging modalities including mammography, ultrasonography (US), magnetic resonance imaging (MRI) and positron emission tomography (PET) as well as review literature concerning this uncommon condition.

Primary Breast Extranodal Marginal Zone Lymphoma in Primary Sjögren Syndrome: Case Presentation and Relevant Literature.

The association between autoimmune diseases, mostly rheumatoid arthritis, systemic lupus erythematosus, celiac disease and Sjögren syndrome, and lymphoma, has been widely demonstrated by several epidemiologic studies. By a mechanism which has not yet been entirely elucidated, chronic activation/stimulation of the immune system, along with the administration of specific treatments, may lead to the onset of different types of lymphoma in such patients. Specifically, patients affected by Sjögren syndrome may develop lymphomas many years after the original diagnosis. Several epidemiologic, hematologic, and histological features may anticipate the progression from Sjögren syndrome into lymphoma but, to the best of our knowledge, a definite pathogenetic mechanism for such progression is still missing. In fact, while the association between Sjögren syndrome and non-Hodgkin lymphoma, mostly extranodal marginal zone lymphomas and, less often, diffuse large B-cell, is well established, many other variables, such as time of onset, gender predilection, sites of occurrence, subtype of lymphoma, and predictive factors, still remain unclear. We report on a rare case of primary breast lymphoma occurring three years after the diagnosis of Sjögren syndrome in a 57-year-old patient. The diagnostic work-up, including radiograms, core needle biopsy, and histological examination, is discussed, along with emerging data from the recent literature, thus highlighting the usefulness of breast surveillance in Sjögren syndrome patients.

METABOLIC SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY WITH THE NEW RADIOPHARMACEUTICAL ⁹⁹ᵐTc-1-thio-D-glucose IN THE DIAGNOSIS AND MONITORING OF THE PRIMARY BREAST LYMPHOMA (CASE REPORT)

The article shows the feasibility of detecting and monitoring primary breast diffuse large B-cell lymphoma using single-photon emission computed tomography (SPECT) with 99mTc-1-thio-D-glucose (99mТс-TG), a new radiopharmaceutical. The innovative radiopharmaceutical makes it possible to evaluate the metabolism of tumor tissue without using positron emission tomography. The findings of 99mTc-TG SPECT obtained during diagnosis and monitoring of the patient were confirmed by the results of computed tomography. A comprehensive examination of the patient, including 99mTc-TG SPECT, made it possible to diagnose a rare case of primary breast lymphoma. Primary breast lymphoma accounts for 1.7–2.2 % of all extranodal nonHodgkin lymphomas. Diffuse large B-cell lymphoma is the most common histological type occurring usually as a unilateral palpable tumor in middle-aged women. Extranodal lymphomas account for less than 0.5 % of all malignant neoplasms of the breast. After 6 courses of immunochemotherapy, the patient underwent 99mTc-TG SPECT, which demonstrated persistent hypermetabolic activity in the breast. The patient received radiation therapy to the remaining tumor of the left breast. The patient is in remission and followed up at the Cancer Research Institute of Tomsk National Research Medical Center. Thus, 99mTc-TG SPECT is believed to be a promising method for visualizing primary breast lymphomas and assessing their treatment outcomes. It is an alternative to the standard approach using 18F-FDG positron emission tomography. The method compares favorably with positron emission tomography with its wide availability and low cost of study. 

METABOLIC SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY WITH THE NEW RADIOPHARMACEUTICAL ⁹⁹ᵐTc-1-thio-D-glucose IN THE DIAGNOSIS AND MONITORING OF THE PRIMARY BREAST LYMPHOMA (CASE REPORT)

The article shows the feasibility of detecting and monitoring primary breast diffuse large B-cell lymphoma using single-photon emission computed tomography (SPECT) with 99mTc-1-thio-D-glucose (99mТс-TG), a new radiopharmaceutical. The innovative radiopharmaceutical makes it possible to evaluate the metabolism of tumor tissue without using positron emission tomography. The findings of 99mTc-TG SPECT obtained during diagnosis and monitoring of the patient were confirmed by the results of computed tomography. A comprehensive examination of the patient, including 99mTc-TG SPECT, made it possible to diagnose a rare case of primary breast lymphoma. Primary breast lymphoma accounts for 1.7–2.2 % of all extranodal nonHodgkin lymphomas. Diffuse large B-cell lymphoma is the most common histological type occurring usually as a unilateral palpable tumor in middle-aged women. Extranodal lymphomas account for less than 0.5 % of all malignant neoplasms of the breast. After 6 courses of immunochemotherapy, the patient underwent 99mTc-TG SPECT, which demonstrated persistent hypermetabolic activity in the breast. The patient received radiation therapy to the remaining tumor of the left breast. The patient is in remission and followed up at the Cancer Research Institute of Tomsk National Research Medical Center. Thus, 99mTc-TG SPECT is believed to be a promising method for visualizing primary breast lymphomas and assessing their treatment outcomes. It is an alternative to the standard approach using 18F-FDG positron emission tomography. The method compares favorably with positron emission tomography with its wide availability and low cost of study. 

PRIMARY BREAST LYMPHOMA: A CASE SERIES AND REVIEW

The primary breast lymphoma (PBL) is a rare manifestation of extranodal non-Hodgkin’s lymphoma. The clinical features are indistinguishable to that of breast carcinoma. They usually do not have characteristic clinical and imaging findings. The pre-operative diagnosis of PBL is difficult and the diagnosis is based on biopsy and immunohistochemical staining. Diffuse large B-cell lymphoma is the most common histological diagnosis. We retrospectively analyzed four cases of PBL who attended at our center, between 1997 and 2019 and discussed to determine the common clinical features and therapy. These cases were originally treated by chemotherapy, that is, rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP/CHOP) or combined chemotherapy and radiotherapy and had recurrence in the central nervous system (CNS). Due to the high incidence of CNS involvement in these patients, many authors strongly believe that patients with aggressive forms of PBL should receive CNS prophylaxis, even in the early stages, as this may improve the outcome and significantly reduce the risk of a CNS relapse.

Primary Bilateral Malignant Non-Hodgkin’s Lymphoma of the Breast: A Case Report and Review of the Literature

Primary breast lymphoma (PBL) is considered a rare clinical entity, representing approximately 0.4% to 0.5% of all breast tumors. In this report, we present a case of Primary breast lymphoma in a 19-year-old woman complaining of a lump in the right breast and a nodule in the left breast. Breast imaging pointed towards PBL which was confirmed by the results of immunohistochemistry. The case was eventually diagnosed as non-Hodgkin’s type B lymphoma. The management of PBL and carcinomas is completely different. The value of preoperative diagnosis should be emphasized, as the patient avoids unnecessary surgery and begins chemotherapy earlier.

A Case of Primary Breast Lymphoma with Contralateral Breast Cancer

A Case of Primary Breast Lymphoma with Contralateral Breast Cancer

Diffuse Large B-Cell Breast Lymphoma: A Case Series.

Primary breast lymphoma (PBL) is a rare disease, and few clinicohistopathologic features of the disease have been discussed in previous studies. It represents 2.2% of extranodal lymphomas and constitutes 0.04% to 0.5% of malignant breast neoplasms, despite the clinical and radiographic similarities between breast lymphoma and carcinoma, the prognosis, as reported in the literature, varies. No consensus exists on the best way to treat PBL. However, radiotherapy and chemotherapy were used alone or in combination to treat various cases of PBL. We retrospectively studied 3 cases of PBL of the breast seen in patients attending a tertiary cancer center in Qatar, between 2012 and 2015, in an attempt to determine the common clinical features, therapy, and prognosis of PBL.

Primary non-Hodgkin's lymphoma of breast – A rare cause of breast lump

We, here, report a case of primary breast lymphoma in a 59years old female. The diagnosis was suspected on fine needle aspiration cytology and confirmed on excision biopsy of the tumor. Histology and immunophenotyping were in accordance with non-Hodgkin's diffuse large B-cell lymphoma. The patient has been planned for adjuvant chemoradiation. The management and outcome of primary breast lymphoma and carcinoma are totally different. Early and prompt diagnosis of primary breast lymphoma is of utmost importance to avoid unnecessary mastectomies. Fine needle aspiration cytology supplemented by immuno-cytochemistry can be applied as a reliable and cost-effective tool in the early diagnosis of primary breast lymphomas, while histopathology and immunohistochemistry are conclusive.

Analysis of ultrasonic characteristics of primary breast lymphoma

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis. Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology. Results All of 21 cases with primary breast lymphoma were solid mass. The contours of 16 cases were regular, and the boundaries of 9 cases were clear. 20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration. The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs. The rear echoes of 17 cases were neither enhanced nor fading. The surrounding tissues of 19 cases were not changed. 13 cases had more than 3 blood vessels on color Doppler imaging. Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma. Key words: Breast neoplasms; Lymphoma; Ultrasonography

Primary Breast Lymphoma in an Immunocompromised Male Patient: A Case Report

Breast lymphomas constitute about 0.04 to 1% of malignant mammary neoplasms; approximately 1.7% to 2.2% of all lymphomas occur in the breast. Breast lymphoma may occur as a primary extranodal involvement of the breast or as secondary infiltration by systemic disease at the time of either initial diagnosis or disease recurrence. Primary breast lymphoma in a male patient is a rare clinical entity and altogether, only 1% of all malignant breast tumors occur in male patients. Patients having either primary or secondary immunodeficiency states are predisposed to developing non-Hodgkin’s lymphoma (1). Here, we report a case of primary breast lymphoma in a secondary immunocompromised male patient. CASE REPORT

[Clinical and prognostic analysis of 21 cases of primary breast lymphoma].

目的探讨原发性乳腺淋巴瘤（PBL）患者临床特征及治疗方法对预后的影响。方法对2003年至2013年所收治的21例PBL患者的临床资料进行回顾性分析。根据治疗方案的不同对患者进行分层分析，比较手术、预防性腰穿鞘注、利妥昔单抗应用对患者疗效和预后的影响。结果21例患者中6例行乳腺肿块穿刺活检术，2例行乳腺癌改良根治术，其余均行单纯乳腺肿块切除术后经病理学检查明确诊断。其中弥漫大B细胞淋巴瘤（DLBCL) 17例，黏膜相关淋巴组织结外边缘区B细胞淋巴瘤（MALT淋巴瘤）、滤泡性淋巴瘤、Burkitt淋巴瘤、皮下脂膜炎样T细胞淋巴瘤各1例。所有患者中仅1例肿块直径>7 cm (MALT淋巴瘤患者），其余均<5 cm。治疗后完全缓解（CR)19例，部分缓解和疾病进展各1例。中位随访14(6~75)个月，21例患者中1例死亡，3年总生存（OS)率为92.3%。化疗+手术组(15例）患者的无进展生存（PFS)时间较单纯化疗组（6例）延长，差异有统计学意义（60个月对22个月，P=0.015），但两组患者的CR率和OS时间差异无统计学意义（P值均>0.05）。20例CD20阳性患者中接受利妥昔单抗治疗者17例，与未接受的3例比较，CR率和PFS、OS时间差异均无统计学意义（P值均>0.05）。8例患者接受预防性腰穿鞘注治疗，与13例未接受者比较，中枢神经系统浸润发生率差异无统计学意义(P=0.381)。结论PBL以DLBCL多见，治疗效果较好，手术治疗仅为明确诊断，并不延长患者OS时间。PBL患者行预防性腰穿鞘注治疗不降低中枢神经系统浸润发生率。

A Case of Primary Breast Diffuse Large B-Cell Lymphoma Treated with Chemotherapy Followed by Elective Field Radiation Therapy: A Brief Treatment Pattern Review from a Radiation Oncologist's Point of View.

We here report a case of primary breast lymphoma (PBL). A 44-year-old woman presented with a painless mass in the right breast. Fine needle aspiration cytology and excisional biopsy were performed. Excisional biopsy revealed low grade lymphoma, which was subsequently confirmed with histopathology and diagnosed as diffuse large B-cell lymphoma (DLBCL). A chest computed tomography scan revealed a 3.5 cm sized breast mass with skin thickening and a small sized lymphadenopathy in the ipsilateral axilla. Radiation therapy including the right whole breast and ipsilateral axilla and supraclavicular lymph node was performed after the patient received four courses of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab) chemotherapy. At the follow-up period of 42 months, the patient is surviving with no evidence of disease. No morbidities occurred in this patient during the follow-up period. We also briefly review the current practice pattern in PBL patients with DLBCL.

Primary breast lymphoma: A report of two cases

Involvement of breast by lymphoma is rare. It occurs as a primary breast tumor or as an extranodal manifestation of a systemic disease. Bilateral primary breast lymphoma (bilateral PBL) is still rarer. The most common type is diffuse large B-cell lymphoma (DLBCL). We are reporting two cases of primary breast lymphoma (PBL), one in a 62-year-old married female and another in a 26-year-old unmarried female. Both the cases were diagnosed by aspiration cytology and confirmed by immunohistochemistry. Early diagnosis of PBL by fine-needle aspiration cytology (FNAC) can avoid unnecessary surgical treatments.

First pathological study of canine primary breast lymphoma and the description of its clinicopathological characteristics as an animal model for human primary breast lymphoma.

Canine breast cancer (BC) and human BC are the most prevalent tumors in female dogs and humans, respectively. Several studies have indicated that canine BC is a good model for human BC. Unlike breast carcinomas, human primary breast lymphoma (PBL) is a rare tumor, but no case of canine PBL has been reported thus far. The current study presents a case of canine MC of the primary non-Hodgkin lymphoma (NHL) type for the first time and subsequently questions the theory of considering it as a model for human PBL. A 2-cm tumor was surgically removed from the left caudal abdominal mammary gland of a 6-year-old female dog of the terrier breed. Microscopic examination did not show any sign for the epithelial origin of the tumor. By contrast, histomorphological view and molecular pathological evaluation by immunohistochemistry showed that the tumor was of the diffuse large B-cell lymphoma (DLBCL) type [cluster of differentiation 19+ (CD19+), CD20+, CD10+, B-cell lymphoma 6+, CD3-, CD15-]. According to the World Health Organization classification, DLBCL is considered to be an NHL. Canine NHL is common in dogs and certain investigators believe that the biological behavior and clinical course is extremely similar to human NHL, and therefore, consider it as a model of human NHL. To the best of our knowledge, the current study is the first report of canine PBL. As the most significantly reported human PBL histotype is the DLBCL type, the histomorphological and immunophenotyping characteristics of canine PBL in the study considerably match with human PBL and raise the hypothesis that it can be a model for human PBL.

Acoustic radiation force impulse (ARFI) imaging of preliminary mucosa associated lymphoid tissue (MALT) lymphoma in the breast: a case report.

Primary lymphoma is a rare neoplasm in the breast accounting for between 0.04% and 0.5% of all malignant mammary tumors. The majority of cases lack typical features of breast malignancy or lymphoma, and likely to be misdiagnosed during daily clinical practice. In this report we describe a case of primary breast lymphoma assessed with acoustic radiation force impulse (ARFI) technology.

MR imaging of malignant primary breast lymphoma: including diffusion-weighted imaging, histologic features, and a literature review

To investigate the magnetic resonance (MR) imaging characteristics of malignant primary breast lymphoma (PBL), including features on diffusion-weighted imaging (DWI). The MR findings of three patients were reviewed retrospectively at our institutions. The signal intensity, shape, enhancement pattern, and DWI findings were examined and correlated with the histologic features. We also reviewed the MR findings of cases of PBL reported in the literature. The tumors in our cases showed early enhancement with penetrating vessels on early-phase dynamic MR images and a strong high signal intensity on DWI. The tumors had a cerebroid appearance and septal enhancement on delayed contrast-enhanced MR images, and we speculate that the fibrous tissue seen in the tumors may correspond to septal enhancement. After chemotherapy, all lesions decreased in size, while the ADCs were increased. All of the cases reported in the literature showed early or avid enhancement; this finding was similar to that observed in our cases. Although based on a small number of cases, we suggest that strong enhancement with penetrating vessels in masses on early images of dynamic MR, strong high intensity on DWI, a cerebroid appearance, and septal enhancement are useful diagnostic clues for a diagnosis of PBL.

Three Cases of Combined Therapy in Primary Breast Lymphoma (PBL) with Successful Outcomes

Primary malignant lymphoma of the breast is a rare tumor, defined as a tumor localized in the breast with or without axillary lymph-node metastases. Such a tumor is mainly found in female patients and located more frequently in the right breast. It is difficult to make primary breast lymphoma (PBL) diagnosis before operation, and PBL diagnosis is mainly based on pathological biopsy and immunohistochemical staining. In this paper, the cases of three patients who had PBL, and who were treated for it at the Institute for Oncology and Radiology of Serbia between 2008 and 2012, are reviewed and discussed. These cases of PBL had no recorded reoccurrence of the disease and were originally treated by surgery, radiotherapy R-CHOP, and/or chemotherapy. While there is no consensus to the question of how to best treat PBL (ie, with chemotherapy, radiotherapy, or combined therapy), it is hoped that this review will offer insight into successful treatment procedures for tumors of this category.

Primary breast lymphoma sequentially relapsed in the peripheral and central nervous system

Primary breast lymphoma (PBL) is an uncommon extranodal type of lymphoma, exhibiting more aggressive behavior and poorer prognosis. Patients with PBL have a higher incidence to relapse in central nervous system (CNS), which is always leading to a dismal outcome even treating with high intensity chemotherapy plus radiotherapy. Lymphoma involving the peripheral nervous system (PNS), either primarily or secondarily, is also rare. But no PBL with PNS relapse has been reported before. Herein, we reported a case of PBL who presented with subsequent relapse in two discrete sites of the PNS followed by the CNS.