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Mremi A, Chipongo H, Urassa E, Mkwizu E, Lodhia J. Primary Breast Lymphoma: A Case Report of a Common Tumor in an Uncommon Location. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2024; 17:2632010X241276947. [PMID: 39246687 PMCID: PMC11380124 DOI: 10.1177/2632010x241276947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 08/02/2024] [Indexed: 09/10/2024]
Abstract
Primary breast lymphoma (PBL) is a rare malignant lymphoid neoplasm limited to the breast, accounting for about 0.15% of all malignant breast tumors and 1.7% to 2.2% of extra-nodal lymphomas. PBL must be distinguished from conventional breast carcinomas due to different therapeutic approaches. A 25-year-old female presented with a left breast mass. Histopathology and immunohistochemical tests confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL). She had no similar lesions elsewhere in the body. She received 1 cycle of R-CHOP chemotherapy but absconded from the treatment and succumbed afterward while at home. Recent developments in DLBCL treatment have greatly improved patient outcomes by incorporating targeted medicines like rituximab, increased chemotherapy regimens, new drugs, and individualized treatment techniques. PBL appears to have a worse prognosis; thus, delay or abscondment from treatment is of serious concern when it comes to improving the prognosis of patients with PBL.
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Affiliation(s)
- Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Research, Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Hilary Chipongo
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Ellyagape Urassa
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Elifuraha Mkwizu
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Jay Lodhia
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Mitala Y, Ssenkumba B, Nabulya R, Kitenda FN, Tumwesigye H, Birungi A, Dratu Chau R, Mushabe B, Baker N, Atwine R. Primary Breast Burkitt Lymphoma. A Case Report of a 16-Year-Old Female with a Rapidly Growing Unilateral Breast Mass. Cancer Manag Res 2023; 15:1047-1052. [PMID: 37790899 PMCID: PMC10543409 DOI: 10.2147/cmar.s426780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Primary breast Burkitt lymphoma is extremely rare. Commonly endemic Burkitt lymphoma presents with abdominal, jaw, periorbital, or genitourinary mass. Case Presentation We report a case of a 16-year-old girl with rapidly enlarging left breast swelling associated with evening fevers. This was later confirmed to be stage 1 primary breast Burkitt lymphoma involving the left breast. This represents the first described case of primary breast endemic Burkitt lymphoma in Uganda. She was started on chemotherapy and exhibited an impressive response to the drugs. Conclusion This case raises awareness of rare sites for endemic Burkitt lymphoma in Uganda. Accurately diagnosing this case was of great importance since it determined the treatment modality (mastectomy or not) which would have an everlasting impact on her life.
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Affiliation(s)
- Yekosani Mitala
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Brian Ssenkumba
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Rita Nabulya
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Francis Nsumba Kitenda
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Habert Tumwesigye
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Abraham Birungi
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Richard Dratu Chau
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Branchard Mushabe
- Department of Pediatrics, Mbarara Regional Referral Hospital, Mbarara City, Uganda
| | - Nichole Baker
- Department of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Raymond Atwine
- Department of Pathology, Mbarara University of Science and Technology, Mbarara City, Uganda
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Santiago-Sanabria L, Garza-Arrieta J, Porras-Ibarra GD, Malfavón-Farias M. Linfoma no Hodgkin de células B primario de mama. Reporte de caso y revisión de la literatura. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2023; 74:53-67. [PMID: 37093942 PMCID: PMC10174716 DOI: 10.18597/rcog.3844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 01/24/2023] [Indexed: 04/25/2023]
Abstract
OBJETIVOS reportar un caso de linfoma no Hodgkin de células B primario de mama (LPM) y realizar una revisión de la literatura de su diagnóstico y tratamiento. Materiales y métodos: se reporta el caso de una paciente de 80 años que acudió a una institución privada de referencia en México por un LPM. Además, se diagnosticó un melanoma primario de hígado, mediante biopsia dirigida y estudio de patología. La paciente recibió tratamiento con R-CHOP (rituximab, ciclofosfamida, doxorrubicina, vincristina y prednisona), cuadrantectomía, resección de cadenas ganglionares y radioterapia. La paciente presenta adecuada respuesta del LPM, sin embargo, el segundo tumor primario progresa llevando a la paciente a cuidados paliativos. Se realizó una búsqueda bibliográfica en Medline vía PubMed, LILACS y Google Scholar. Se incluyeron estudios de cohortes, reportes y series de casos en pacientes con LPM que abordaran el diagnóstico, tratamiento y pronóstico de esta patología, publicados en inglés y español entre los años 2000 a 2022. RESULTADOS se identificaron 23 títulos, de los cuales 17 cumplieron con los criterios de inclusión, estos fueron reportes de caso y series de caso. La mayoría de las pacientes recibió un esquema quimioterapéutico R-CHOP, el cual se complementó con radioterapia. Cerca del 80 % presentó remisión completa. El sitio más frecuente de recaída fue el sistema nervioso central. La sobrevida a 5 años fue del 83,6 % en los estudios incluidos. CONCLUSIONES en la actualidad, el esquema CHOP -con o sin rituximab- es el más empleado y el único que ha mostrado tener un impacto positivo en la supervivencia, este suele acompañarse de radioterapia. Se requieren más estudios clínicos aleatorizados para establecer de manera más clara la efectividad y seguridad de estos tratamientos.
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Rezkallah EMN, Elsaify A, Tin SMM, Dey D, Elsaify WM. Breast lymphoma: General review. Breast Dis 2023; 42:197-205. [PMID: 37393489 DOI: 10.3233/bd-220051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023]
Abstract
BACKGROUND Lymphoma of the breast can be classified as either primary breast lymphoma (PBL) or secondary to systemic lymphoma (SBL). PBL is a rare disease with Diffuse Large B cell Lymphomas (DLBCL) being the most common subtype. OBJECTIVES In the current study, we represented eleven cases diagnosed with breast lymphoma in our trust; two of them had PBL and nine had SBL. We focused mainly on the clinical presentation, diagnosis, management and outcomes. METHODS We did this retrospective review for all breast lymphoma patients who were diagnosed in our trust during the periods from 2011-2022. Patients' data were obtained from the hospital recording system. We followed up these patients thus far to identify the outcome of treatment in each patient. RESULTS Eleven patients were included in our review. All patients were females. Average age of diagnosis was 66.1 ± 13 years of age. Eight patients were diagnosed with DLBCL, two patients were diagnosed with follicular lymphomas, and the last one had lymphoplasmacytic lymphoma. Chemotherapy +∕- radiotherapy was the standard treatment regimen in all patients. Four patients passed away within one year of chemotherapy, five patients achieved complete remission, one patient had two relapses and is still under treatment, while the last patient was diagnosed recently and still awaiting treatment. CONCLUSION Primary breast lymphoma is an aggressive disease. The treatment for PBL is mainly systemic with chemoradiotherapy. The role of surgery is now limited to the diagnosis of the disease. Early diagnosis and proper treatment are crucial for the management of such cases.
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Affiliation(s)
- Emad M N Rezkallah
- General Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | | | - Su M M Tin
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - Debdeep Dey
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - Wael M Elsaify
- General Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
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Abstract
Primary breast lymphoma (PBL) is an uncommon type of breast malignancy. Its clinical presentation and radiographic findings are non-specific and overlap with breast carcinoma. The treatment of PBL differs significantly from breast carcinomas. Here we present a middle-aged woman who presented with an enlarging palpable right breast mass. Mammogram showed breast imaging-reporting and data system 4 findings. Breast mass biopsy pathology confirmed diffuse large B cell lymphoma. Although uncommon, clinicians should be cognisant of the possibility of PBL when patients present with a breast mass. Accurate diagnosis is essential to avoid unnecessary mastectomies.
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Affiliation(s)
- Mengni Guo
- Internal Medicine Residency, AdventHealth Orlando, Orlando, Florida, USA
| | - Jieying Liu
- Internal Medicine Residency, AdventHealth Orlando, Orlando, Florida, USA
| | - Richard Gilmore
- Breast Surgical Oncology, West Cancer Center, Memphis, Tennessee, USA
| | - Gang Gary Tian
- Medical Oncology/Hematology, West Cancer Center, Memphis, Tennessee, USA
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James ER, Miranda RN, Turner SD. Primary Lymphomas of the Breast: A Review. JPRAS Open 2022; 32:127-143. [PMID: 35402679 PMCID: PMC8987598 DOI: 10.1016/j.jpra.2022.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/06/2022] Open
Abstract
Lymphomas of the breast are rare neoplasms that arise from breast lymphoid tissue and are characterised by neoplastic B or T cells. Breast lymphomas arising from B cells include, but are not limited to, diffuse large B cell lymphoma, follicular lymphoma, extra-nodal marginal zone lymphoma and Burkitt lymphoma. Anaplastic large cell lymphoma (ALCL) is of a T cell origin and both anaplastic lymphoma kinase (ALK)-positive and ALK-negative presentations have been noted in the breast. In addition, there is a more recently identified presentation of ALK-negative ALCL that arises around textured breast implants and is usually confined to a periprosthetic fibrous capsule. Here, we discuss the clinical presentations, histological and immunohistochemical features and treatment options for each type of primary breast lymphoma. We hope that this review will highlight the importance of the timely and accurate diagnosis of breast lymphoma in order to tailor the most appropriate treatment. We also wish to raise awareness of the breast implant-associated lymphomas, with the goal of stimulating work that will aid our understanding of their epidemiology and pathogenesis.
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Cunningham I, Sánchez Sosa S, Hamele-Bena D. Single organ microenvironment and the common features of tumors of leukemia, lymphoma, and myeloma cells growing there: A literature review. Eur J Haematol 2021; 108:169-177. [PMID: 34779527 DOI: 10.1111/ejh.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore whether the growth and treatment resistance of lymphoma and myeloma tumors is similar to that previously observed in leukemic and solid tumors growing in the same organ microenvironment. METHODS All published cases of 3 primary hematologic malignancies in breast, without systemic involvement, were identified, with follow-ups solicited from authors. Treatment approaches were analyzed to highlight the most effective. RESULTS Similar histologic features and biology among primary tumors of leukemia, lymphoma, plasmacytoma, and solid breast cancer was revealed. Review of treatments: tumor-directed, chemotherapy, or combination showed the benefit of tumor removal, and use of systemic agents in adjunct, not primary, treatment. Optimal assessment is limited by few cases of PET/CT verifying limited tumor extent. The common biology observed and cases of long survival after tumor/stroma eradication point to the complicity of organ microenvironment in the chemoresistance and treatment failure commonly observed in patients. CONCLUSIONS The interaction of an organ microenvironment, particularly its adipocytes, with malignant cells, results in similar histologic changes, metastatic potential, and chemoresistance in 3 hematologic malignancies and solid cancers. Improved survival in hematologic malignancies could result from adopting PET/CT to find tumor and its extent, eradicating tumor, and elucidating common therapeutic targets.
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Affiliation(s)
- Isabel Cunningham
- Division of Hematology Oncology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | | | - Diane Hamele-Bena
- Department of Pathology & Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
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Uenaka N, Yamamoto S, Sato S, Kudo T, Adachi S, Narui K, Tanabe M, Yamada A, Ishikawa T, Endo I. Primary breast lymphoma initially diagnosed as invasive ductal carcinoma: A case report. Clin Case Rep 2021; 9:e04189. [PMID: 34194774 PMCID: PMC8222742 DOI: 10.1002/ccr3.4189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 01/23/2023] Open
Abstract
A malignant tumor in the breast may not be conclusive of breast cancer. It is important to keep the possibility of primary breast lymphoma in rare scenarios. For the diagnosis of primary breast lymphoma, immunohistochemical staining is necessary.
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Affiliation(s)
- Natsuki Uenaka
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
- Department of Breast Surgery and OncologyTokyo Medical UniversityShinjuku‐kuJapan
| | - Shinya Yamamoto
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Seiya Sato
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Takamichi Kudo
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Shoko Adachi
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Kazutaka Narui
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Mikiko Tanabe
- Department of PathologyYokohama City University Medical CenterYokohamaJapan
| | - Akimitsu Yamada
- Department of Gastroenterological SurgeryYokohama City University Graduate School of MedicineYokohamaJapan
| | - Takashi Ishikawa
- Department of Breast Surgery and OncologyTokyo Medical UniversityShinjuku‐kuJapan
| | - Itaru Endo
- Department of Gastroenterological SurgeryYokohama City University Graduate School of MedicineYokohamaJapan
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