Primary Breast Lymphoma Research Articles

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 Diffuse Large B-Cell Lymphoma of the Breast: A Rare Case Report and Review of the Literature

BACKGROUND: Breast lymphomas are rare extranodal lymphomas. They constitute a tiny percentage of malignant tumors of the breast and a small subset of extranodal lymphomas. The rarity of breast lymphomas is attributed to the very scanty lymphoid tissue content of the chest wall. AIMS OF STUDY: This case report aims to provide an up-to-date review of the literature on breast lymphomas and clinicians to consider the possibility of this disease entity while treating a breast mass. CASE PRESENTATION: A case is reported of primary mammary non-Hodgkin lymphoma in a 52-year-old man. Fine needle aspiration cytology (FNAC) was inconclusive. Incisional biopsy-confirmed primary breast lymphoma was diagnosed as the diffuse large B-cell type: non – Hodgkin lymphoma. He had complete disease remission in response to chemotherapy – Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (CHOP). After that, the patient did not require further surgical intervention. He was followed up at two-monthly intervals for eighteen months in the surgical outpatient clinic with no disease recurrence and satisfactory clinical outcome, following which he discontinued follow-up visits. CONCLUSION: While assessing breast masses, clinicians must recognize primary non-Hodgkin lymphoma as a potential differential diagnosis. A core biopsy of breast masses is needed to exclude it, and appropriate treatment must be given if diagnosed.

Combination of baseline total metabolic tumor volume measured on FDG-PET/CT and β2-microglobulin have a robust predictive value in patients with primary breast lymphoma.

The aim was to build a prognostic model to stratify patients at diagnosis into different risk categories. We investigated the prognostic value of functional PET parameters and clinical features in 64 primary breast lymphoma (PBL) patients. With a median follow-up of 60 months, 5-year progression-free survival (PFS) and overall survival (OS) was 62.5% and 73.4%. In multivariate analysis, baseline total metabolic tumor volume (TMTV0) and β2-microglobulin remained more reliable predictors of survival than other prognostic factors. The optimal TMTV0 cut-off value was 90 cm3 . Among 29 patients with high TMTV0, 5-year PFS and OS were 44.8% and 62.1%, respectively, while 5-year PFS and OS of 35 patients with low TMTV0 were 74.3% and 85.7%, respectively. TMTV0 combined with β2-microglobulin identified three groups with very different prognosis, including low-risk group with low TMTV0 and β2-microglobulin≤normal (n = 30), intermediate-risk group with high TMTV0 or β2-microglobulin>normal (n = 20), and high-risk group with high TMTV0 and β2-microglobulin>normal (n = 14). In the three groups, 5-year PFS rates were 80%, 55% and 28.6% (P = .003), and 5-year OS rates were 90%, 65%, and 50% (P = .023) respectively. We established a new prognostic model through TMTV0 and β2-microglobulin, and can divide PBL at diagnosis into different risk categories.

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.

Comparison of Clinical Features Between Primary and Secondary Breast Diffuse Large B Cell Lymphoma: A Yokohama Cooperative Study Group for Hematology Multicenter Retrospective Study.

We performed a retrospective analysis of DLBCL with breast involvement to compare the prognosis of primary breast lymphoma (PBL) to secondary breast lymphoma (SBL; especially in limited stage cases). We retrospectively reviewed records of 25 diffuse large B-cell lymphoma (DLBCL) patients with breast involvement who received chemotherapy between January 2000 and August 2012. We compared clinical features and prognosis among patients with PBL (n = 11), limited stage SBL (LSBL; n = 6), and advanced stage SBL (ASBL, n = 8). The PBL group had significantly lesser patients with breast tumours (BTs) > 5cm than the SBL group (P = 0.02). After a median follow-up of 71.3months, we observed significantly better 5-year overall survival (OS) in the PBL group (90.0%) than in the LSBL (33.3%, P = 0.01) group, but not for progression-free survival (PFS). Patients with BT > 5cm had worse OS (P = 0.01) and PFS (P = 0.04) than those with BT ≤ 5cm. PBL had a better prognosis than SBL among limited stage DLBCL.

Primary Breast Lymphoma: Case Report Of A Rare Pathological Entity

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.

Clinical Characteristics and Outcomes of Primary Breast Lymphoma: The Cleveland Clinic Experience.

IntroductionPrimary breast lymphoma (PBL) is a rare malignancy that accounts for less than 0.5% of all breast malignancies.Materials and MethodsWe retrospectively analyzed 36 PBL patients to report the clinical characteristics and outcomes of patients with indolent and aggressive histologic subtypes.ResultsThirteen (36%) patients had aggressive and 23 (64%) had indolent PBL. Marginal zone lymphoma was the most common histologic subtype (33%). Stage IE, IIE, and IV disease were seen in 27 (75%), six (17%), and three (8%) patients, respectively. Patients with aggressive PBL more often presented with a breast lump and/or B symptoms (unexplained weight loss, fever, night sweats) (78% vs. 31%, p = 0.005). Commonly used treatment modalities for aggressive vs. indolent PBL were chemotherapy alone (23% vs. 26%, p = 0.8), chemoradiotherapy (46% vs. 9%, p = 0.009), radiotherapy alone (15% vs. 22%, p = 0.6), and observation (0% vs. 26%, p = 0.07), respectively. The five-year overall survival (OS) and progression-free survival (PFS) of PBL patients were 82% (95% CI: 67 - 100) and 63% (95% CI: 45 - 89), respectively. The five-year OS of patients with aggressive vs. indolent PBL were 92% (95% CI: 77 - 100) vs. 80% (95% CI: 63 - 100), respectively (p = 0.6). The five-year OS of patients who received > 1, 1, and 0 treatment modalities were 92% (95% CI: 77 - 100), 86% (95% CI: 63 - 100), and 53% (95% CI: 21 - 100), respectively.ConclusionIn our cohort, the higher utilization of chemoradiotherapy in aggressive PBL was able to overcome the worse prognosis of these patients. At least one treatment modality should be considered in patients with indolent PBL, given that observation alone was associated with a poor prognosis.

Primary Breast Lymphoma – A Case Report

Primary Breast Lymphoma – A Case Report

Imaging Characteristics of Breast Lymphoma; a Case Series.

Breast involvement by lymphoma is rare. It can occur as a primary breast tumour or as an extranodal manifestation of the systemic disease. The imaging features of breast lymphoma (BL) are not characteristic. Biopsy is necessary for diagnosis due to non-specific imaging features. A retrospective electronic medical chart review was conducted of patients diagnosed with lymphoma of breast that underwent diagnostic radiological procedures (including mammography, ultrasound breast, computed tomography (CT) scan and positron emission tomography (PET/CT) scan from 1 July 2018 to 31 March 2019 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan. Four patients were identified. On mammogram, the most common finding consisted of the presence of high-density masses with circumscribed or indistinct margins. On ultrasound, hypoechoic masses and indistinct diffuse infiltrative patterns were observed. PET/CT and CT were helpful in detecting extramammary sites of disease and for classifying the disease into primary or secondary BL. The early diagnosis of the BL is important. The radiologists should include lymphoma in the differential diagnosis when there is the absence of microcalcifications or spiculated margins on mammography and ultrasound.

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 diagnostic surprise in a breast lump: Primary T-cell non-Hodgkin's lymphoma

Unilateral primary breast lymphoma (PBL) is a rare entity usually occurring in elderly women and when present is of B-cell variety. We present a premenopausal female who presented with an asymptomatic breast lump whose initial investigations were inconclusive but for final histopathology and immunohistochemistry that revealed a non-Hodgkin's PBL of T-cell variety that is extremely rare. A detailed review has been presented.

A case report of diffuse Large B - Cell Lymphoma of breast associating an ovarian tumor

Described for the first time in 1959, Primary non-Hodgkin´s lymphoma of the breast is a rare clinical entity which clinical presentation and radiological description is not different from other breast malignancies. Due to the rarity of cases and the few cases reported in studies, the management has still no clear guidelines. The management and outcome of primary breast lymphoma and carcinoma are totally different. Early and prompt diagnosis of primary breast lymphoma is important to avoid unnecessary mastectomies. We are reporting a case of a nulliparous patient aged of 30 with family history of colon cancer who consulted first for the management of a pelvic mass and the exam revealed a breast mass, which was diagnosed as diffuse large B-cell Lymphoma. No diagnosis could be found for the ovarian tumor as the patient passed away under investigation.

Rituximab-CHOP and Central Nervous System Prophylaxis Using Intrathecal Methotrexate in Primary Breast Diffuse Large B-Cell Lymphoma: A Prospective, Multicenter, Single-Arm Phase II Study

Background: Primary breast diffuse large B-cell lymphoma (DLBCL) has poor outcomes with frequent extranodal failures, particularly in the central nervous system (CNS). To prevent CNS recurrence, we designed this phase II trial that addressed feasibility and activity of conventional immunochemotherapy and CNS prophylaxis. Methods: This prospective, multicenter, single-arm phase II study was conducted to evaluate efficacy and safety of 6 cycles of conventional rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone every 21 days (R-CHOP) with the addition of 4 doses of intrathecal methotrexate (IT MTX; 12mg) during the first 4 cycles of R-CHOP in patients with primary breast DLBCL. Primary breast lymphoma was defined as lymphoma involving one or both breasts as a sole extranodal site regardless of specific nodal involvement status. The primary end-point was 2-year progression-free survival (PFS). Secondary end-points included cumulative incidence of CNS recurrence, overall survival (OS), and safety. All patients provided written informed consents and the study was registered at www.clinicaltrials.gov as #NCT01448096. Results: Thirty-three patients with primary breast DLBCL were enrolled between Jan 2012 and Jul 2017 in the Consortium for Improving Survival of Lymphoma (CISL) member institutions. The median age was 50 years at diagnosis (range, 29-75) and all were female. Right breast involvement was more common than left (18 [55%] vs 14 [42%]) and bilateral breast involvement was found in one patient (3%). Nodal involvement was present in 16 patients (49%), primarily in regional nodes (14 patients). Thus, the Ann Arbor stage was IE in 17 (52%), IIE in 13 (39%), IIIE in 2 (6.1%), and IV in 1 (3.0%). ECOG performance status was ≥2 in 1 patient (3%) and serum LDH level was elevated in 9 (27%). Therefore, the IPI and the CNS-IPI risk were mainly low (28 patients, 85%; respectively). No patients had CNS involvement at diagnosis. 32 (97%) of the 33 patients completed R-CHOP as planned, and the remaining patient withdraw a consent after four cycles of R-CHOP because of poor tolerance. CNS prophylaxis using IT MTX was completed as planned in 31 patients (94%), but it was discontinued in 2 patients because of patient's refusal. These 2 patients received two and three IT MTX doses, respectively. 32 patients (97%) were evaluable for treatment response and all these patients achieved a complete response. At the cutoff date of this analysis (10 Jul 2019), all patients who entered a follow-up phase had at least 24.0 months of follow-up. With a median follow-up duration of 46.1 months (IQR 31.1-66.8), 6 patients had experienced treatment failure and 3 of these died. The 2-year PFS and OS were 81.3% (95% CI, 67.7-94.8) and 93.5% (95% CI, 84.9-100.0), respectively (fig 1A and B). Of the 6 patients with treatment failure, diseases involved CNS with or without lymph nodes in 4 patients and breasts in 2 patients (1 ipsilateral and 1 contralateral breast recurrence). 3 of the four patients with CNS recurrence had isolated CNS recurrences (2 brain parenchymal and 1 meningeal disease) and one had a concurrent meningeal and lymph nodal recurrence. All 4 patients with CNS recurrence had received prophylactic IT MTX as planned by protocol. The 2-year cumulative incidence of CNS recurrence, taking into account the competing risk of death, was 12.5% (95% CI, 0.3-23.2, fig 1C). Although the number of patients with intermediate CNS-IPI risk was small (5 patients, 15%), the cumulative incidence of CNS recurrence did not differ significantly according to the CNS-IPI risk group. All CNS recurrences occurred within the first 2 years after enrolment. Toxicities were generally manageable during the R-CHOP and IT MTX treatment. No deaths as a result of toxicity occurred during treatment. Conclusion: Our study shows that conventional R-CHOP with prophylactic IT MTX is feasible in patients with primary breast DLBCL. However, given a substantially high rate of CNS recurrence, further studies to properly define the best strategy for CNS prophylaxis should be needed in patients with primary breast DLBCL. Figure 1 Disclosures Yoon: F. Hoffmann-La Roche Ltd: Research Funding. Kim:Celltrion: Research Funding; Novartis: Research Funding; Donga: Research Funding; Kyowa-Kirin: Research Funding; Novartis: Research Funding; J + J: Research Funding; F. Hoffmann-La Roche Ltd: Research Funding.

EP37.04: Sonographic findings and clinicopathological characteristics of primary breast lymphoma

EP37.04: Sonographic findings and clinicopathological characteristics of primary breast lymphoma

Contralateral Breast Diffuse Large B Cell Malignant Lymphoma With Previous MALT Lymphoma

Background: Breast involvement during malignant lymphomas is a rare condition, whether in primary or secondary cases, whereas according to the literature, primary breast lymphomas represents merely less than 0.5% of the breast malignancies.Case Presentation: The case was a 48 years-old patient referred to the clinic with contralateral breast diffuse large B cell malignant lymphoma. She had an operation for right breast mucosa-associated lymphoma tissue (MALT) lymphoma two-years earlier. The participant experienced surgical excision of the right breast mass and radiotherapy subsequently. Surprisingly, after two years she developed a mass on the left breast, for which we were not able to establish an evident relationship between the earlier MALT lymphoma and the second diffused B cell lymphoma.Conclusion: Although, our report emphasizes on the undeniable role of the breast examination in prevention of catastrophic events, we are far from providing diagnostic approaches on breast MALT lymphoma, due to minimal case sizes and lack of adequate information and evidences.

Primary and Secondary Breast Lymphoma: Focus on Epidemiology and Imaging Features.

Aim of this study was to select all the cases of Primary (PBL) and Secondary (SBL) Breast Lymphoma from our breast unit since 01/01/2000, to obtain up-to-date data on the prevalence of this rare pathology and to analyze imaging features, with a special focus on CT. All pathological reports of breast biopsies performed from 01/01/2000 to 01/01/2019 were at first screened. Among them, we performed two different researches, looking for key words suggesting either a diagnosis of lymphoma or any other malignant disease. Using the Wiseman criteria, we identify PBL and SBL. All imaging features of PBL and SBL were analyzed. Prevalence of lymphoma amongst suspicious breast masses and amongst all breast malignancies were calculated. Out of 42,505 histopathology reports from mammary nodule biopsies, we found 19,354 malignancies. We were able to identify 11 patients affected by PBL (0,03% of suspicious breast lesions, 0.06% of breast malignancies), and 23 cases of SBL (0,05% of suspicious breast lesions, 0,12% of breast malignancies). Most common isotype in PBL was DLBC lymphoma, whereas in SBL that resulted Follicular lymphoma. In PBL group, we were able to retrieve images7 CT or CT-PET study performed at diagnosis 7 US, 1 mammography and and 1 MR. In SBL group, we analyzed 14 CT/CT-PET examinations, 11 US studies and 3 mammography. PBL and SBL are rarer than considered until now. There is no definite imaging characteristic able to distinguish between these two pathologies and among them and breast cancer.

Clinical characteristics and prognosis of primary breast lymphoma: Cleveland Clinic experience.

e19035 Background: Primary Breast lymphoma (PBL) is a rare form of extranodal non-Hodgkin lymphoma (NHL). The majority of PBL are diffuse large B-cell lymphoma (DLBL). Current treatments can achieve an overall survival of 5 years in 80% of the patients. We evaluated prognostic factors and survival rates in PBL patients at Cleveland clinic foundation (CCF). Methods: We retrospectively identified patients diagnosed with PBL at CCF between January 2004 and January 2018. Baseline characteristics were compared between the indolent and aggressive lymphoma groups using two sample T-test for continuous variables, chi-square test and fisher’s exact test for categorical variables. Overall survival (OS) was estimated by the Kaplan-Meier method and compared by the log-rank test. Results: A total of 36 patients with PBL were identified, of whom 35 patients (97.2%) were females with a median age of 66 years (34-95). Of all patients, 23 (63.9%) were indolent lymphoma and 13 (36.1%) were aggressive lymphoma. The most common subtypes were marginal zone lymphoma (33.3%), DLBL (25%) and follicular lymphoma (19.4%). Only 2 patients (5.6%) had implant-associated anaplastic large T-cell lymphoma. There was significant difference in presentation between indolent and aggressive lymphoma patients; 78.3% of indolent lymphoma patients presented with incidental mammogram lesions compared to 30.8% of aggressive lymphoma patients (P-value = .019).Seventy five percent of the patients presented with stage IE, 16.7 % presented with stage IIE and 8.3% presented with stage IV. Treatment received included chemotherapy (55.6%), radiotherapy (47.2%), surgeries (16.7%), and rituximab (80% of patients received chemotherapy). Six patients (16.7%) didn’t receive treatment. Only one patient received central nervous system prophylaxis. Median follow-up of patients was 37.1 months. Three-year OS for patients with indolent and aggressive PBL was 94.4% (95% CI 84.4% - 100%) and 90.9% (95% CI 75.4% - 100%), respectively (p = 0.69). Conclusions: Marginal zone lymphoma was the most common subtype in our cohort. Indolent lymphoma commonly present as incidental mammogram finding. Prognosis of PBL is not affected by histologic subtype, tumor stage and bilateral breast involvement. Current treatments achieve good control of the disease.

Primary breast lymphoma in a male patient

Primary breast lymphoma in a male patient

Incidental Primary Breast Lymphoma on 99mTc-Sestamibi Myocardial Perfusion Imaging With SPECT/CT

We present a 53-year-old woman who had shortness of breath and atypical chest pain and underwent Tc-sestamibi myocardial perfusion imaging to detect coronary artery disease. The raw data in cine format showed an incidental focus close to the heart, and SPECT/CT fused images revealed a focus of intense uptake in the left breast. The subsequent histopathologic findings and F-FDG PET/CT imaging confirmed the diagnosis as primary breast lymphoma. After 3 cycles of chemotherapy, previously visualized abnormal uptake in the left breast disappeared on the follow-up PET/CT.