Primary non-Hodgkin Lymphoma Research Articles

A 67-year-old Female with Malignant Splenic Non-Hodgkin Lymphoma at Banten Regional General Hospital: A Case Report

Non-Hodgkin's lymphoma (NHL) is a type of lymphoproliferative disorder primarily involving lymph nodes but can extend to extranodal sites like the spleen. When NHL originates in the spleen, it is classified as primary splenic NHL. Due to its unusual presentation, it may resemble other splenic conditions in clinical appearance. In this Journal we report a rare case of splenic lymphoma in a 67-year-old female with symptoms of abdominal pain in the left quadrant of the abdomen. Multislice Computerized Tomography (MSCT) scan of the abdomen to axial pelvis section showed splenomegaly with solid mass et causa suspect splenic lymphoma. The diagnosis of malignant splenic non-Hodgkin lymphoma can be made after splenectomy and histopathology examination which is consistent with clinical and radiologic examination found in the Patient.

Histopathological characteristics and management of primary breast non-Hodgkin lymphoma: a case-series

Histopathological characteristics and management of primary breast non-Hodgkin lymphoma: a case-series

Comparison of clinical features of patients with or without severe gastrointestinal complications in aggressive gastrointestinal lymphomas.

Aggressive primary gastrointestinal non-Hodgkin lymphoma (PGINHL) is an uncommon and heterogeneous group of lymphoid malignancies, that differs from indolent lymphoma and has a high incidence of severe gastrointestinal complications (GICs). To investigate and compare the clinicopathological characteristics, treatments and outcomes in the GICs and No-GICs group with aggressive PGINHL. This retrospective analysis was performed on aggressive PGINHL patients between January 2013 and December 2021 at our hospital. The independent influence factors of GICs were obtained by univariate and multivariate Logistic regression analysis, the selected variables significantly related to GICs were selected as the final predictors to construct nomogram. Kaplan-Meier curves further analyzed the survival of patients in GICs and No-GICs groups. Survival analysis of GICs group was performed using Cox regression. We focused on 124 aggressive PGINHL cases, which had a relatively high incidence 48.4% (60/124 cases) of GICs, the most common histological type in GICs group was diffuse large B-cell lymphoma (DLBCL) (n = 49, 81.7%). In the GICs group, small intestine was the most common anatomic site of lesion (43.3%), followed by large intestine (31.7%), and then stomach and esophagus (25.0%). Multivariate Logistic regression analysis showed that the independent risk factors for GICs were the small intestine [odd ratio (OR) = 3.33; 95% confidence interval (CI): 1.47-9.41; P = 0.009), aggressive B-cell (OR = 0.09; 95%CI: 0.01-0.83; P = 0.033), maximum tumor diameter (OR = 1.25; 95%CI: 1.07-1.47; P = 0.005), invaded deep serous layer (OR = 3.38; 95%CI: 1.24-9.19; P = 0.017). We developed a nomogram to predict risk of GICs in aggressive PGINHL patients based on independent risk factors. The value of area under curve calculated by receiver operating characteristic curve was 0.815, and calibration curve and decision curve analysis further indicated that the prediction effect was superior. The majority of patients with GICs were given combination therapy (chemotherapy combined with surgery or radiation). Event-free survival and overall survival in GICs group were no worse than those in the No-GICs group. The complication rate of GICs in patients with aggressive PGINHL was relatively high, particularly in PGI-DLBCL. The independent risk factors for GICs were the small intestine, PGI-TNKL, bulky tumor, and depth of invasion. A combination treatment, involving surgery, improved survival in the GICs group.

Risk of second primary cancers in nodal non-Hodgkin lymphoma patients by primary lymph node location: a retrospective cohort population-based study.

Non-Hodgkin lymphoma (NHL) is a diverse group of blood cancers with increasing incidence and survival rates due to advancements in treatment and early detection. However, NHL survivors are at significant risk of developing second primary cancers, which can adversely impact their long-term survival. This retrospective population-based cohort study utilized data from the Surveillance, Epidemiology, and End Results database, covering 17 geographic areas in the United States from 2000 to 2021. The authors included patients diagnosed with nodal NHL as a first primary cancer and excluded those diagnosed at autopsy or via death certificate only. Standardized Incidence Ratios, Absolute Excess Risks, and Person-Years at Risk were calculated to evaluate the risk of developing SPCs according to the primary lymph node site and stratified by latency periods following the initial NHL diagnosis. The cohort included 54012 NHL patients. The authors' results showed that for most SPCs, the risk of development was different for different primary NHL lymph node locations. The highest risks were observed for thyroid cancer, acute myeloid leukemia, and Hodgkin lymphoma. Notably, the risk for thyroid cancer was highest in the first year post-diagnosis, while hematological malignancies such as acute myeloid leukemia and Hodgkin lymphoma showed elevated risks in the intermediate and late latency periods. NHL survivors are at an increased risk of developing SPCs, influenced by the primary lymph node site and latency period. These findings highlight the need for tailored surveillance strategies and preventive measures to mitigate the long-term risks of SPCs in NHL survivors. Further research is necessary to elucidate the underlying mechanisms and to develop targeted interventions for this high-risk population.

Pediatric B-cell Non-Hodgkin Lymphoma: The Impact of Therapy Response and Relapse on Outcome. A Single-center Analysis.

Pediatric patients with primary refractory or relapsed B-cell non-Hodgkin lymphoma (B-NHL) have highly unfavorable prognosis. In this study, we retrospectively analyzed outcomes in pediatric B-NHL patients treated in a single center in Poland from 1995 to 2022, with emphasis on therapy results in patients with progression or relapse. The primary objectives were a 5-year probability of overall survival (pOS) and a 5-year probability of event-free survival (pEFS). The secondary objectives involved the assessment of prognostic factors. A total of 76 children were eligible for the analysis. The 5-year pOS was 76.7%, and the 5-year pEFS was 72.9%. At diagnosis, elevated lactate dehydrogenase activity, the presence of B symptoms, bone marrow, skeletal or mediastinal involvement, and stage IV disease were associated with inferior outcomes. Nine children experienced progression and four relapse. The 5-year pOS for patients with progression was 38.1%. Two patients treated with hematopoietic stem cell transplantation (HSCT) as part of salvage therapy survived. However, only one out of seven patients who were treated without HSCT survived. The 5-year pOS was 0.0% in patients with relapsed disease. The most significant factor related to outcomes in pediatric B-NHL is therapy response, with a high mortality rate in children with refractory disease and relapse. There is no consensus on the salvage therapy approach; however, HSCT appears to be the optimal choice.

Prognostic and survival factors in head and neck extra-nodal non-Hodgkin's lymphoma

To make a clinical-biological characterization of this pathology and assess the survival of these patients and the associated prognostic factors. A retrospective observational study was designed to identify primary extranodal non-Hodgkin lymphomas of the head and neck diagnosed between January 1, 2005, and January 1, 2016. Cases were considered if they presented with a single tumor in situ or if the extranodal component was clinically predominant. A total of 145 patients were included. Localized stages (I-II) were present in 69.3%. Overall, 91.8% were B-cell phenotype, with diffuse large B-cell lymphoma being the most frequent. Overall, 78% of patients were treated with immunochemotherapy. The overall survival at 3 and 5 years was 75% and 73%, respectively. Adverse prognostic factors were: low hemoglobin, elevated ß2-microglobulin, and lactate dehydrogenase (LDH) levels, Eastern Cooperative Oncology Group (ECOG), stage III/IV, and B symptomatology at diagnosis. The progression-free survival at 3 and 5 years was 71% and 68%. Risk factors for relapse were high ß2-microglobulin, high LDH, and stage III-IV at diagnosis. These pathologies show a good response to treatment with immuno-polychemotherapy. Factors associated with a worse prognosis included low hemoglobin, elevated levels of ß2-microglobulin and LDH, elevated ECOG, stage III/IV, and B symptomatology at diagnosis.

Diffuse large B-cell lymphoma in the uterus with unexpected manifestations: a case report

BackgroundLymphoid neoplasm is a common disease, arising from lymphoid cells. It is divided into Hodgkin lymphoma and non-Hodgkin lymphoma. Non-Hodgkin lymphoma can be intranodular or extranodular, which happens in 25% of primary cases. The most common locations of extranodular non-Hodgkin lymphoma are the skin and gastrointestinal tract. The genital tract is a rare location; most lymphomas arise from the cervix and vagina, while the uterine corpus is an extremely rare location. In our case, the patient was diagnosed with primary extranodular non-Hodgkin lymphoma in different locations of her genital tract.Case presentationA 48-year-old nonparous Syrian woman complained of diffuse abdominal pain, fatigue, debility, high fever, vomiting, and urinary retention for a week. The last menstrual period of the patient was 5 years previously. The physical examination showed periodic abdominal pain with severe fatigue and increased abdominal size. The laboratory investigations were within normal limits except for a low level of hemoglobin and a high level of cancer antigen 125. The radiological investigations showed a uterine sizable lobulated mass with irregular borders and high and heterogeneous density, extending to the right and left ovaries, enlargement lymph nodes around the abdominal aortic and right iliac vessels, and severe right pleural effusion with right inferior lobe atelectasis. A total hysterectomy and oophorectomy were done. The histopathological examination showed that the patient had non-Hodgkin lymphoma (primary tumor).ConclusionPrimary non-Hodgkin lymphoma in the female genital tract is an extremely rare disease. Fast diagnosis and treatment can improve the outcomes, so this differential diagnosis should be in our minds even in the absence of systematic manifestations of lymphoma. More studies are needed to explain the pathology of this disease and to put guidelines that determine the perfect methods for diagnosis and treatment.

Odd Ball Paradigms of Rhino Facial Swellings: A Diagnostic Dilemma of Primary Subcutaneous Non-Hodgkin Lymphomas

Odd Ball Paradigms of Rhino Facial Swellings: A Diagnostic Dilemma of Primary Subcutaneous Non-Hodgkin Lymphomas

Scrutinizing prognostic scores’ effectiveness in non-Hodgkin’s lymphomas with primary lymph node involvement

Introduction. Non-Hodgkin lymphoma (NHL) encompasses a diverse group of malignancies arising from malignant proliferation of lymphocytes, each subtype characterized by unique epidemiological, etiological, and clinical features. Prognostication is essential for guiding treatment decisions and improving patient outcomes. Prognostic scores, including traditional and molecular systems, offer insights into survival prediction. The aim of the present study was to evaluate the applicability of traditional prognostic scores based on clinical markers and laboratory biomarkers in predicting the outcomes of patients with primary nodal NHL. Materials and methods. This study included 78 NHL patients treated at the Chisinau Oncological Institute from 2017 to 2021. Clinical and biological data were collected, and the following prognostic scores were calculated: International Prognostic Index (IPI), The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP score), Platelet to Lymphocyte Ratio (PLR), Neutrophil to Lymphocyte Ratio (NLR), Albumin/Globulin ratio (AG), and Charlson comorbidity index (CCI). Statistical analyses, including descriptive statistics, ROC curve analysis, and Kaplan-Meier survival curves, were conducted. Results. Of the patients, 40 (51.2%) were female, with a mean age of 57.1 ± 10.2 years. Peripheral lymph nodes were predominantly affected (84.6%), with diffuse large B-cell lymphoma being the most prevalent subtype (59.0%). Prognostic scores, including the International Prognostic Index (IPI), Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, and Charlson Comorbidity Index (CCI), demonstrated varying levels of discriminatory ability in predicting overall survival (OS). Notably, the HALP score (AUC = 0.650; p = 0.026), IPI (AUC = 0.745; p = 0.0002), and CCI (AUC = 0.636; p = 0.043) were statistically significant predictors of OS. Conclusions. Traditional prognostic scores (IPI. HALP score, CCI) offer valuable prognostic information for NHL patients. Further research is needed to validate these findings and explore cost-effective prognostic strategies.

Radical Radiotherapy in Primary Extra Nodal Lymphoma of Tonsil: A Rare Case Report

Primary non-Hodgkin’s lymphoma (NHL) usually arises within the lymphnodes, but 20-30% account for extranodal sites. Non-Hodgkin’s lymphoma (NHL) of the Waldeyer’s ring is a clinical rarity. Among these tumors, palatine tonsils are most frequently involved. Most common high-grade rapidly growing NHL is diffuse large B-cell lymphoma (DLBCL), reaching about 80% in some of the studies. For aggressive localized Extranodal Lymphoma, systemic therapy is the primary treatment modality unless patients are unfit for, or refuse, such therapy. Here, we report a 71 years old elderly gentleman who presented with complaints of left tonsillar swelling, difficulty in swallowing and change in voice since 10 days. He was diagnosed as localised Primary Extra nodal NHL - DLBCL of left tonsil. But he was unfit for chemotherapy in view of elderly age and multiple comorbidities, hence he received radical radiotherapy. During the treatment, he had symptomatic relief. He responded to radical radiotherapy well & is on regular follow up.

Clinical characteristics and prognostic analysis of primary extranodal non-Hodgkin lymphoma of the head and neck.

Primary extranodal non-Hodgkin's lymphoma (PE-NHL) of the head and neck is the second common site of extranodal lymphoma, accounting for approximately one-third of all extranodal non-Hodgkin's lymphoma (E-NHL). However, in recent years, large-scale PE-NHL case studies in China and worldwide are rare and not comprehensive enough. This work analyzed the clinical manifestations, pathological features, immunophenotypes and diagnosis of PE-NHL, as well as the factors affecting the treatment and prognosis. A retrospective study was performed on 74 patients who were diagnosed with head and neck PE-NHL and treated for the first time. The clinical manifestations, pathological features, and immunophenotypes were summarized, and the factors related to the treatment and prognosis were analyzed. The most common site of this disease was the Waldeyer's ring, followed by the nasal cavity. Diffuse large B-cell lymphoma was the most common type, followed by extranodal NK T-cell lymphoma nasal type. The 1-year, 2-year, and 5-year progression-free survival (PFS) rates were 76.4%, 67.9%, and 59.3%. The 1-year, 2-year, and 5-year overall survival (OS) rates were 89.4%, 85.6%, and 63.2%. ECOG score ≥ 2, Ann Arbor stage III or IV and IPI risk stratification identifying patients as the high-risk group were independent risk factors affecting the OS of patients with PE-NHL of the head and neck. The most common site of PE-NHL in these Chinese patients was the Waldeyer's ring, but the incidence in the nasal cavity was higher than that reported in Western countries. Radiotherapy combined with chemotherapy had better efficacy than chemotherapy alone, and the prognosis depended on the ECOG score and clinical stage. IPI had a better prognostic value in patients in the high-risk group of head and neck PE-NHL.

Primary bone solitary B-cell lymphoblastic lymphoma aberrant expression Fli-1 and ERG: A case report.

Primary non-Hodgkin bone lymphoma is a rare disease, and within this category, B-cell lymphoblastic lymphoma (B-LBL) is an even rare clinical entity that has only been reported in small case series or individual case reports. B-LBL can mimic Ewing's sarcoma both clinically and histologically, leading to misdiagnosis. We present a case of primary B-LBL of the bone in a 7-year-old girl. The tumor cells are uniform and small with a diffuse and infiltrative growth pattern similar to EWS. Immunohistochemical results are positive for CD99, Fli-1, ERG, TDT, PAX5, and CD79α, but negative for leukocyte common antigen, CD3, CD20, and NKX2.2. No other lesions are found on positron emission tomography/computed tomography imaging. Finally, primary solitary bone B-LBL of the right tibia was diagnosed.

Incidence and survival of second primary non-Hodgkin lymphoma: A Surveillance, Epidemiology, and End Results-based cohort study.

The aim of this study was to investigate patient survival and factors associated with survival in second primary non-Hodgkin lymphoma (NHL) compared with the first primary NHL. The retrospective cohort study used data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2014. Demographic characteristics, histological types, Ann Arbor stage, and treatment information were collected. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with overall survival (OS) and cancer-specific survival (CSS) in the first and second primary NHLs. Of 318,168 cases followed for 5 years, 299,248 patients developed the first primary NHL and 18,920 patients developed the second primary NHL. This study identified a rising incidence of first and second primary NHL from 2000 to 2014. For the second primary NHL, the OS risk was higher when compared to the first primary NHL (HR: 1.13, 95% CI: 1.11 to 1.15, P <0.001). Risk factors that negatively affected OS in the first primary NHL included being male, over 40 years of age, certain marital statuses, specific histological types, and advanced disease stages. In contrast, being of White race and having histological types such as Follicular Lymphoma (FL), Marginal Zone Lymphoma (MZL), and mantle B-cell NHL were associated with better OS outcomes. Treatments like surgery, radiation therapy, and chemotherapy were associated with a lower risk of OS and CSS in the first primary NHL. For the second primary NHL, the detrimental risk factors were similar but also included being over the age of 60. Certain histological types showed a lower OS risk relative to diffuse Large B-cell Lymphoma (DLBCL). While surgery and chemotherapy were beneficial for OS, radiation therapy did not improve survival in second primary NHL cases. Notably, undergoing chemotherapy for the first primary cancer increased the OS risk in the second primary NHL, whereas surgery and radiation seemed to offer a protective effect against OS risk in the second primary NHL (all P <0.05). Our findings emphasize the need for tailored strategies in managing the second primary NHL, given the distinct survival patterns and risk factor profiles compared to the first primary NHL. Future research should aim to further elucidate these differences to improve prognosis and treatment approaches for second primary NHL patients.

Эндоскопическая семиотика гастритоподобной формы первичных неходжкинских лимфом желудка

Aim. To characterize the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric non-Hodgkin lymphomas (NHL).&#x0D; Materials &amp; Methods. This prospective study analyzes the results of complex endoscopic diagnosis in 43 patients with primary gastric NHL. They were examined and treated at the NN Blokhin National Medical Cancer Research Center from 2019 to 2023. The patients were 30–70 years of age, those over the age of 50 predominated and accounted for 79 % (n = 34). There were 33 women and 10 men. The control group included 45 patients with gastritis-like malignant gastric tumors: adenocarcinoma and signet-ring cell cancer.&#x0D; Results. The morphological analysis yielded a diagnosis of MALT-lymphoma in 90.7 % (n = 39) and diffuse large B-cell lymphoma in 9.3 % (n = 4) of cases. Sensitivity, specificity, and accuracy of the clarification methods of complex endoscopic diagnosis were considerably higher compared to white-light mode examination. According to the results of complex endoscopic analysis, all patients were stratified into 4 groups with different types of H. pylori-induced atrophic gastritis (n = 10; 23.25 %), erosive gastritis (n = 10; 23.25 %), hyperplastic gastritis (n = 8; 18.6 %), and combined gastritis (n = 15; 34.9 %). The focus was laid on identifying the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric NHL which distinguish it from the lesions in other malignant tumors.&#x0D; Conclusion. The complex examination using 4 concrete clarification methods of endoscopic diagnosis is indispensable to properly interpret the detected changes and timely diagnose the gastritis-like form of primary gastric NHL. These include narrow-band imaging (NBI/BLI and LCI), close-focus and magnification examinations, combined narrow-band imaging and magnification examination, as well as endosonography.

Primary Non-Hodgkin Lymphoma of Breast in Young Female-A Rare Entity

Primary Non-Hodgkin Lymphoma of Breast in Young Female-A Rare Entity

Laryngeal Lymphoma: A Case Report

Primary laryngeal lymphoma is a rare entity, accounting for less than 1% of all primary laryngeal neoplasms. It is mainly primary non-Hodgkin's malignant lymphoma (NHLM). We report a new case in a 56-year-old woman who presented with progressive onset dysphonia [1]. Laryngoscopy revealed a budding lesion of the glotto-supglottic level (vocal cords, arytenoids, ventricular bands, epiglottis). Histology showed a peripheral T-cell lymphoma, CD3 and Ki67 positive, this pathology is difficult to diagnose, requires particular vigilance and should be managed according to current treatment trends for nodal LMNH.

Late Presentation of a Primary Spinal Epidural Non-Hodgkin Lymphoma

Primary spinal epidural lymphomas (PSELs) constitute a unique subset of epidural tumors characterized by the exclusive presence of lymphoma within the epidural space at initial presentation, with no concurrent lymphoma in other sites. We aim to present a unique of PSEL and compare it with the present literature This case report presents a 65-year-old female with delayed-onset primary spinal epidural non-Hodgkin lymphoma (NHL). The patient exhibited paraplegia and walking difficulties, following a year of lower-extremity weakness and tingling sensations. Magnetic resonance imaging revealed a mass in the L1 through L3. Surgical decompression, stabilization, and tumor resection were performed. Microscopic examination confirmed NHL. Chemotherapy with the CHOP regimen was administered postsurgery. Subsequent follow-up revealed motoric and sensory improvements. PSEL primarily affects the thoracic spine and is more common in males. Patient age and gender impact prognosis. PSEL typically exhibits two phases – prodromal and rapid neurological deterioration. Surgical intervention coupled with chemotherapy is recommended, but the optimal surgical approach varies. Combined therapy could lead to improved disease-free survival. Cases of PSEL have shown potential for local and systemic relapse. Late presentation can still yield improvements with surgical and prompt chemotherapeutic intervention. Even without a prior history of malignancy or significant disease, PSEL should still be considered in patients presenting with spinal compression symptoms. Cases of delayed presentation, like the one presented here, can still benefit from surgical and prompt chemotherapeutic intervention.

A Retrospective Study of 341 Cases of Primary Extranodal Non-Hodgkin Lymphoma of the Head and Neck

Aims: Our goal was to obtain comprehensive and accurate information about primary extranodal non-Hodgkin lymphomas of the head and neck region to contribute to the advancement of medical knowledge in this field. Materiels and methods: We conducted a retrospective study of 341 patients with primary extra-nodal, non-Hodgkin lymphomas of the head and neck, over a period of 7 years from January 2016 to December 2022, in the departments of ENT and Head and Neck Surgery and Hematology, with the help of the department of anatomical pathology of the university hospital Mohammed VI of Marrakech. Results: 341 patients, with primary extra-nodal, non-Hodgkin lymphomas of the head and neck, was included, with an average age of 57 years, and a sex ratio male/female of 2.21 . in more than half of the cases; Waldeyer's ring was concerned; especially palatine tonsils. Type B NHL was the most frequent and involved 308 patients. Diffuse large B-cell lymphoma was the commonly observed histological type, found in 214 patients; followed by a Follicular Lymphoma and Extra-Nodal NK/T‑Cell Lymphoma, Nasal Type. Following the extension workup; patients were all staged according to the ANN ARBOR classification; with a 77.8% of them were localized stages I and II, and of the therapeutically evaluable cases, complete remission was achieved in 112 patients. Conclusion: Our study focused on all extra-nodal localizations of NHL in the head and neck region. Due to the very heterogeneous nature of these tumors, most of the current studies are limited to a specific site of involvement. Nevertheless, our study provides an overall picture; which those specific studies can be based. The management of NHL has evolved considerably in recent years, insisting on the multidisciplinary character to a better management of these patients.

Breast lymphoma mimicking benign breast lesions: A diagnostic challenge

Abstract: NHL Primary of the breast is rare accounting 0.1% of the total malignancy. DLBCL is the most common histology for Primary NHL breast. It presentation is similar to carcinoma breast so biopsy followed by IHC is only method to differentiate between both. Due to rarity of the tumor there is lack of literature on proper diagnosis and treatment. RCHOP is the chemotherapy regime used and radiotherapy role is not clear. Some studies suggest role of CNS irradiation in high risk patient because of high chances of CNS spread in advance stage patient. In this paper we aim to highlight the diagnostic difficulties we faced and the treatment we followed. Here we bring to the knowledge of the reader about the review over diagnosis, clinical feature and treatment of NHL breast along side with two clinical cases to enhance clinical interest of the reviewer.

Series of rare cases of breast tumour: 8-year review at mankweng Breast Oncology clinic, Limpopo, South Africa

Breast cancer remains the most common cancer in many parts of the world, particularly for women. In March 2015, a Breast Oncology clinic for breast cancer patients was established at Mankweng Hospital. Invasive ductal carcinoma is the most common (87 %) tumour found in Limpopo, and occasionally, another rare tumour of the breast is presented in the Breast Oncology clinic.&#x0D; The aim: The main objective is to share the experience of a rare tumour of the breast came across over the past 8 years since the establishment of the Breast Oncology clinic.&#x0D; Material and Method: Series of rare case reports of Breast tumours and literature review from the Mankweng Breast Oncology Clinic.&#x0D; Result: Rare tumour encountered in Breast Oncology clinic: adenomyoepithelioma, micro-papillary carcinoma of the breast, primary malignant melanoma of the breast, primary non-Hodgkin's lymphoma of the bilateral breast, advanced breast cancer in a case of Down's syndrome, primary neuroendocrine invasive breast carcinoma, sarcoma of the breast.&#x0D; Conclusions: Most of these rare cases are presented to the Breast Oncology clinic in the advanced stage. Breast cancer awareness campaign is highly important for women in Limpopo, particularly when attending primary health care for any other conditions.