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Steven W, Szarmach JL, Raghu M, Bakhru S, Everett T, Flaherty F, Boroumand G. A rare case of primary breast lymphoma presenting as calcifications on screening mammography. Radiol Case Rep 2024; 19:1734-1739. [PMID: 38384692 PMCID: PMC10877128 DOI: 10.1016/j.radcr.2024.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
Extranodal marginal zone lymphoma (EMZL) is a low-grade subtype of B-cell non-Hodgkin lymphoma that can affect any mucosal tissue, most commonly the GI tract. Primary involvement of the breast, known as primary breast lymphoma (PBL), is a very rare manifestation. We report an unusual case of a 65-year-old woman with primary breast EMZL presenting as calcifications discovered during screening mammography. This represents an exceedingly atypical appearance of primary breast lymphoma that is rarely described in the literature.
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Affiliation(s)
- Wojtkiewicz Steven
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Jaime L Szarmach
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Madhavi Raghu
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Seema Bakhru
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Todd Everett
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Francis Flaherty
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
| | - Gilda Boroumand
- Department of Radiology, Norwalk Hospital, 34 Maple St, Norwalk, CT 06850, USA
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2
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Antúnez YO, Dávila Zablah YJ, Ávila JRV, Macías GSG, Montemayor MLG. Secondary breast lymphoma: A case report. Radiol Case Rep 2024; 19:1313-1318. [PMID: 38292778 PMCID: PMC10825539 DOI: 10.1016/j.radcr.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 02/01/2024] Open
Abstract
Lymphoma is the most frequent hematologic malignancy that involves the breast. It represents less than 1% of all breast cancer. The most common subtype is the secondary B-cell lymphoma. Clinically, lymphomas are divided into primary and secondary breast lymphoma. We presented a case of 49-year-old female, who has diagnosed of Non-Hodgkin's Lymphoma, finalizing the treatment 2 months ago. Currently, she came for a check-up due to a palpable lump in the right breast. Mammography shows a dense, oval, and circumscribed mass. Ultrasound revealed a 3.6 cm oval, hypoechoic, lobulated mass with internal vascularity at color Doppler. Axillary nodes show cortical thickening of 7 mm, cortical blood flood, and absence of fatty hilum. The histopathology report corresponds to infiltration of the right breast and bilateral axillary nodes by Non-Hodgkin Lymphoma. This case corresponds with lymphoma recurrence manifested in breast. The diagnosis of lymphoma is an imaging challenge that simulates benign and malignant pathologies.
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Affiliation(s)
- Yazmin Olivares Antúnez
- Diagnostic Breast Imaging Center of Zambrano-Hellion Hospital, Tecnológico de Monterrey, Av. Batallón de San Patricio 112, Real San Agustín, 66260 San Pedro Garza García, Nuevo León, Mexico
| | - Yesika Janett Dávila Zablah
- Diagnostic Breast Imaging Center of Zambrano-Hellion Hospital, Tecnológico de Monterrey, Av. Batallón de San Patricio 112, Real San Agustín, 66260 San Pedro Garza García, Nuevo León, Mexico
| | - José Raúl Vázquez Ávila
- Patology, Service of San José Hospital, Tecnológico de Monterrey, Av. Ignacio Morones Prieto 3000, Sertoma, 64710 Monterrey, Nuevo León, Mexico
| | - Gabriela Sofía Gómez Macías
- Patology, Service of San José Hospital, Tecnológico de Monterrey, Av. Ignacio Morones Prieto 3000, Sertoma, 64710 Monterrey, Nuevo León, Mexico
| | - Margarita Lilia Garza Montemayor
- Diagnostic Breast Imaging Center of Zambrano-Hellion Hospital, Tecnológico de Monterrey, Av. Batallón de San Patricio 112, Real San Agustín, 66260 San Pedro Garza García, Nuevo León, Mexico
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3
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Lee KE, Woo OH, Kim CY, Cho KR, Seo BK. Unusual US Findings of Diffuse Large B-Cell Lymphoma of the Breast: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2024; 85:415-420. [PMID: 38617862 PMCID: PMC11009123 DOI: 10.3348/jksr.2022.0177] [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: 12/27/2022] [Revised: 07/10/2023] [Accepted: 09/03/2023] [Indexed: 04/16/2024]
Abstract
Lymphoma is an uncommon type of breast malignancy, with low prevalence. The ultrasonographic findings of breast lymphoma have been described as nonspecific. Breast lymphoma most commonly appears as a solitary hypoechoic mass on US, and usually shows hypervascularity on color Doppler US. Herein, we report an unusual case of breast lymphoma that presented as multiple bilateral hyperechoic nodules on US.
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4
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Grover H, Grover SB, Leah Forman F, Khanna G, Margolies L. Multiple bilateral breast masses due to lymphoma metastases: A report of 2 cases highlighting the mammographic and sonographic features. Radiol Case Rep 2024; 19:357-369. [PMID: 38033677 PMCID: PMC10682527 DOI: 10.1016/j.radcr.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 12/02/2023] Open
Abstract
Metastases within breast usually occur due to a primary malignancy in the contralateral breast. Breast metastases from extra mammary malignancies are known to be very rare and the primary tumors are reported to be melanoma, lung cancer, gastro-intestinal primary tumors, neuroendocrine tumors, sarcomas, ovarian tumors and lymphomas. Breast lymphomas comprise 0.04%-0.7% of all cases of breast malignancies and may manifest either as a primary or a secondary variety. A primary breast lymphoma is known to be more infrequent than a secondary breast lymphoma. In patients with breast metastases the usual clinical presentation is with multiple palpable masses and imaging evaluation is the mainstay for initial diagnosis. We report the imaging features seen in 2 almost identical cases of secondary breast lymphoma. At mammography, multiple, round to elliptical, sharply circumscribed, high-density masses were seen, in which spiculation, calcification and architectural distortion were conspicuously absent. On sonography, these round /oval masses were homogenously hypoechoic, sharply circumscribed, showed a thin echogenic rim with posterior acoustic enhancement and were moderately to profusely vascular on color Doppler examination. These imaging features should suggest the possible diagnosis of metastases from a hematogenous malignancy and an ultrasound guided biopsy should be performed. Once the etiology of lymphoma is confirmed, a rigorous multi- modality imaging work up to identify the primary site, stage the disease and document other sites of dissemination is warranted.
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Affiliation(s)
- Hemal Grover
- Department of Radiology, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Shabnam Bhandari Grover
- Department of Radiology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, 201306, Uttar Pradesh, India
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi 110029, India
| | - Frimmit Leah Forman
- Department of Radiology, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Geetika Khanna
- Department of Pathology, VMMC and Safdarjung Hospital, New Delhi 110029, India
| | - Laurie Margolies
- Department of Radiology, Icahn School of Medicine Mount Sinai, New York, NY, USA
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5
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Chen W, Liu F, Wang R, Qi M, Zhang J, Liu X, Song S. End-to-end deep learning radiomics: development and validation of a novel attention-based aggregate convolutional neural network to distinguish breast diffuse large B-cell lymphoma from breast invasive ductal carcinoma. Quant Imaging Med Surg 2023; 13:6598-6614. [PMID: 37869296 PMCID: PMC10585556 DOI: 10.21037/qims-22-1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/24/2023] [Indexed: 10/24/2023]
Abstract
Background Apart from invasive pathological examination, there is no effective method to differentiate breast diffuse large B-cell lymphoma (DLBCL) from breast invasive ductal carcinoma (IDC). In this study, we aimed to develop and validate an effective deep learning radiomics model to discriminate between DLBCL and IDC. Methods A total of 324 breast nodules from 236 patients with baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) were retrospectively analyzed. After grouping breast DLBCL and breast IDC patients, external and internal datasets were divided according to the data collected by different centers. Preprocessing was then used to process the original PET/CT images and an attention-based aggregate convolutional neural network (AACNN) model was designed. The AACNN model was trained using patches of CT or PET tumor images and optimized with an improved loss function. The final ensemble predictive model was built using distance weight voting. Finally, the model performance was evaluated and statistically verified. Results A total of 249 breast nodules from Fudan University Shanghai Cancer Center (FUSCC) and 75 breast nodules from Shanghai Proton and Heavy Ion Center (SPHIC) were selected as internal and external datasets, respectively. On the internal testing, our method yielded an area under the curve (AUC), accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and harmonic mean of precision and sensitivity (F1) of 0.886, 83.0%, 80.9%, 85.0%, 84.8%, 81.2%, and 0.828, respectively. Meanwhile on the external testing, the results were 0.788, 71.6%, 61.4%, 84.7%, 84.0%, 62.6%, and 0.709, respectively. Conclusions Our study outlines a deep learning radiomics method which can automatically, noninvasively, and accurately differentiate breast DLBCL from breast IDC, which will be more in line with the needs and strategies of precision medicine, individualized diagnosis, and treatment.
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Affiliation(s)
- Wen Chen
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Fei Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Rui Wang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Ming Qi
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Jianping Zhang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Xiaosheng Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, China
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6
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Bradley M, Kirk K, Mallick J, Posleman Monetto FE. Rare Lymphoma of the Breast: A Case Report. Cureus 2023; 15:e45059. [PMID: 37829979 PMCID: PMC10567211 DOI: 10.7759/cureus.45059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Lymphoma of the breast is a rare malignancy of the breast lymphoid tissue. It can present as either a primary or a secondary malignancy due to metastasis from a systemic disease. Secondary breast lymphoma (SBL) is one of the most common malignancies to metastasize to the breast. Once present in the breast, these masses are often difficult to distinguish from primary breast carcinoma on both physical examination and diagnostic imaging modalities. Differentiating these tumors is imperative because each has a different management plan. This report presents a rare case of SBL in a 55-year-old Hispanic female and includes a review of its presentation, radiologic imaging findings, and management.
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Affiliation(s)
- Megan Bradley
- John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Katie Kirk
- John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Jayati Mallick
- Pathology, University of Texas Medical Branch at Galveston, Galveston, USA
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7
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Wang X, Liu C, Shang G, Xiong J, Zhou H, Tang W, Qin X. Multimodal Ultrasonography Features of Breast Lymphomas: 3 Cases Report. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1353-1359. [PMID: 36502374 DOI: 10.1002/jum.16137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/29/2022] [Accepted: 11/15/2022] [Indexed: 05/18/2023]
Abstract
To investigate the multimodal ultrasonography (US) features of breast lymphomas (BLs). Multimodal ultrasonography was performed on three patients who had been diagnosed BLs by pathology in our hospital. Two cases of primary BLs appeared hyper hyperechoic and hypoechoic, and one case of second BL appeared isoechoic and hypoechoic. Elastography of two lesions was soft elasticity and the elasticity score was 2 points. Contrast-enhanced ultrasound (CEUS) revealed rapid uniform high enhancement with clearly defined after injection. There are some common features in ultrasound. Combined with those features can help to improve the sonographer's understanding and diagnosis of the BLs.
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Affiliation(s)
- Xiuhua Wang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Cong Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Gongqun Shang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jiajia Xiong
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Hui Zhou
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wenjuan Tang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojuan Qin
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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8
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Deb PQ. Primary Lymphoma of Breast: A Population-Base Outcome Analysis. Indian J Hematol Blood Transfus 2023; 39:237-244. [PMID: 37006971 PMCID: PMC10064372 DOI: 10.1007/s12288-022-01581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/08/2022] [Indexed: 04/04/2023] Open
Abstract
The majority of neoplasms of the breast are derived from epithelial components and give rise to carcinoma, namely invasive ductal and lobular carcinoma of the breast. Unlike carcinomas, primary hematolymphoid malignancies of the breast are a rare group of malignant neoplasms. Due to their rarity, these patients' epidemiological features and outcomes have not been studied well. A few limited case series and case reports suggest that this group of heterogeneous neoplasms has female predominance and poor prognosis. However, no systematic study exists to date. In order to bridge this knowledge gap, the National Cancer Institute's Surveillance, Epidemiology, and End Results databases have been quarried and analyzed to investigate the epidemiological and outcome features of primary hematolymphoid malignancies of the breast. This study is one of the first efforts to establish a systematic understanding of the demographic characteristics and the survival features of this rare group of malignancies.
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Affiliation(s)
- Pratik Q. Deb
- Department of Pathology, Immunology & Laboratory Medicine, Rutgers-New Jersey Medical School, 185 S. Orange Ave, 07103 Newark, NJ USA
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9
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Huayanay Espinoza JL, Mego Ramírez FN, Guerra Miller H, Huayanay Santos JL, Guelfguat M. A Spectrum of Metastases to the Breast: Radiologic-Pathologic Correlation. JOURNAL OF BREAST IMAGING 2023; 5:209-229. [PMID: 38416928 DOI: 10.1093/jbi/wbac083] [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] [Received: 03/08/2022] [Indexed: 03/01/2024]
Abstract
Metastases to the breast from non-mammary origin are rare. The majority of these lesions appear as secondary manifestations of melanoma and lymphoma, followed by lung carcinomas, gynecological carcinomas, and sarcomas. There has been a steady trend of an increase in diagnosis of intramammary metastases owing to the current advances in imaging technology. Imaging features depend on the type of primary neoplasm and route of dissemination, some of which resemble primary breast cancer and benign breast entities. There are certain imaging features that raise the level of suspicion for metastases in the correct clinical context. However, imaging manifestations of intramammary metastases do not always comply with the known classic patterns. The aim of this review is to clarify these features, emphasizing radiologic-pathologic correlation and a multidisciplinary approach, since most cases are found in patients with advanced disease.
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Affiliation(s)
| | | | - Henry Guerra Miller
- Instituto Nacional de Enfermedades Neoplásicas, Department of Pathology, Lima, Peru
| | | | - Mark Guelfguat
- Jacobi Medical Center, Department of Radiology, Bronx, NY, USA
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10
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Vorstenbosch J, Chu JJ, Ariyan CE, McCarthy CM, Disa JJ, Nelson JA. Clinical Implications and Management of Non-BIA-ALCL Breast Implant Capsular Pathology. Plast Reconstr Surg 2023; 151:20e-30e. [PMID: 36194076 PMCID: PMC9797444 DOI: 10.1097/prs.0000000000009780] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
SUMMARY The breast implant capsule is a dynamic structure that forms following the implantation of a device. Although normally benign, increased awareness of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) highlights that disease may arise from the capsule. BIA-ALCL presents as a late seroma or mass but explains few of the late seromas found in breast implant patients. To date, many of these seromas lack a clear cause and are often described as "idiopathic." Several benign and malignant breast implant capsular diseases can cause a late seroma or mass, including breast implant-associated squamous cell carcinoma. Similar to early reports of BIA-ALCL, these conditions are rare and largely limited to case reports or series. The purpose of this special topic is to present a narrative review highlighting capsular abnormalities that contribute to the formation of late seroma or mass in an attempt to broaden the differential diagnosis and help plastic surgeons identify the cause. Specifically, we review the presentation and management of BIA-ALCL, synovial metaplasia, capsular epithelialization, late hematoma, double capsule, breast cancer, squamous cell carcinoma, mesenchymal tumor, and B-cell lymphoma. Although rare, plastic surgeons should consider these capsular conditions as causes of late seromas and masses. Usually, these conditions may be diagnosed by following the National Comprehensive Cancer Network screening guidelines for BIA-ALCL. Thorough evaluation and workup of late seromas and masses may lead to improved characterization of these rare breast implant capsular conditions and improve our understanding of their pathophysiology and management.
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Affiliation(s)
- Joshua Vorstenbosch
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jacqueline J. Chu
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Charlotte E. Ariyan
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Colleen M. McCarthy
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph J. Disa
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonas A. Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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11
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Muacevic A, Adler JR. Surgical Excision Versus Medical Management of Primary Breast Lymphoma: A Case Report. Cureus 2022; 14:e32802. [PMID: 36694497 PMCID: PMC9859769 DOI: 10.7759/cureus.32802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Lymphoma of the breast accounts for 0.4-0.5% of all breast-located cancers and is found in a similar fashion to breast cancers. Here we present a 74-year-old woman who presented for a biopsy of a breast mass found on a routine mammogram, which was found to be a primary breast lymphoma. According to current practice guidelines, medical therapy is favorable for the definitive management of primary breast lymphomas. However, biopsy specimen cytology found neoplastic cells positive for human germinal center-associated lymphoma, a nonspecific marker for various types of lymphomas. Without a definitive classification of lymphoma, optimal medical therapy could not be achieved. Therefore, a decision was made to undergo a lumpectomy of the mass, which yielded a specimen that was found pathologically favorable for diffuse large B-cell lymphoma. With this information, the patient was referred to follow-up oncology for adjuvant chemotherapy and radiotherapy.
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12
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Anendaga CDM, Raghu M, Szarmach JL, Bakhru S, Flaherty FT, Boroumand G. A rare case of synchronous mucosa-associated lymphoid tissue (MALT) lymphoma involving bilateral breasts and subcutaneous tissues. Radiol Case Rep 2022; 17:4049-4052. [PMID: 36046719 PMCID: PMC9421087 DOI: 10.1016/j.radcr.2022.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/04/2022] Open
Abstract
Marginal zone lymphoma of mucosa-associated lymphoid tissue is a B-cell lymphoma which arises in extranodal sites, most commonly the stomach. Involvement of the breast is very rare. We present a case of an asymptomatic 63-year-old woman with synchronous mucosa-associated lymphoid tissue lymphoma involving both breasts and subcutaneous tissues. This represents a form of secondary breast lymphoma (given the concurrent involvement of the breast and non-mammary organ systems) and is an exceedingly rare diagnosis which, to our knowledge, has only been discussed in a few case series.
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13
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Luttwak E, Segman Y, Saban M, Gutwein O, Avivi I, Perry C, Filiavich A, Sarid N. Lymphoproliferative disease detected by breast cancer screening. J Med Screen 2022; 29:255-259. [PMID: 35818749 DOI: 10.1177/09691413221109988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the rate of lymphoproliferative disease (LPD) in women undergoing routine breast cancer screening (BCS). BCS can reveal pathologies other than carcinoma that involve the breast and lymph tissue. The few studies that have described cases in which BCS led to the diagnosis of LPD were based on small series and focused on imaging rather than clinical characteristics. SETTING AND METHODS A multi-center retrospective study in Israel, investigating LPD rate and characteristics among women diagnosed with LPD via BCS. RESULTS Thirty-four patients out of 14,400 consecutive women undergoing BCS at Tel Aviv Sourasky Medical Center during the study period were diagnosed with LPD, suggesting a diagnosis rate of 0.24%. The enlarged cohort (n = 45), including 11 patients that were retrieved from the databases of three other centers, demonstrates a predominant histological diagnosis of non-aggressive LPD (n = 33). Thirty-four (76%) had a suspicious axillary lymph node, and 11 had a breast lesion. The median maximal lesion size was 1.95 cm (range 0.8-6.5). Disease was localized in 60% of patients (stage 1 and 1E). Univariate analysis revealed that lymphocyte count was inversely associated with aggressive histology. At median follow-up of 39 months, all but three patients were alive. These three had been diagnosed with non-aggressive LPD which had never been treated and died from unrelated causes. CONCLUSIONS The LPD detection rate via BCS was 2.36 per 1000 screens. The majority of LPDs were non-aggressive. Nearly a third were aggressive, most detected at an early stage, and the clinical outcome was generally favorable.
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Affiliation(s)
- Efrat Luttwak
- Department of Hematology, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yafit Segman
- Department of Hematology, 511918Assuta Ashdod University Hospital, Ashdod, Israel.,Faculty of Health Sciences, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - May Saban
- 58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Odit Gutwein
- 58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology, 37256Shamir Medical Center, Zerifin, Israel
| | - Irit Avivi
- Department of Hematology, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chava Perry
- Department of Hematology, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alina Filiavich
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nadav Sarid
- Department of Hematology, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,58408Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology, 58883Edith Wolfson Medical Center, Holon, Israel
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14
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Giuliano FD, Perretta T, Pitocchi F, Pucci N, Serio ML, Caliandro A, Picchi E, Ferrazzoli V, Pistolese CA, Garaci F, Floris R. Coexistence of primary central nervous system lymphoma and primary breast lymphoma: Clinical presentation, imaging features, and treatment management. Radiol Case Rep 2022; 17:2470-2476. [PMID: 35586158 PMCID: PMC9108739 DOI: 10.1016/j.radcr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/02/2022] [Accepted: 04/05/2022] [Indexed: 11/19/2022] Open
Abstract
The presence of synchronous dual hematological diseases is an uncommon finding. We report an unusual case of coexistence of primary central nervous system lymphoma and primary breast lymphoma without systemic involvement in an immunocompetent patient. To our knowledge a similar case has not yet been reported in the literature. We especially focus on presenting the imaging features, the associated clinical findings and treatment management of each entity, with the aim of raising awareness on these two rare types of lymphomas and the possibility of their coexistence.
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Affiliation(s)
- Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Tommaso Perretta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Francesca Pitocchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Noemi Pucci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
- Corresponding author.
| | - Maria Lina Serio
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Aurelia Caliandro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
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15
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Ferreira LG, Gomes INB, Soares BDAC, Caldas CFNR, Brito LXBA, Castro RMD. Linfoma de Burkitt Primário de Mama: Relato de Caso. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.1961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introdução: O linfoma primário de mama (LPM) representa cerca de 0,5% das neoplasias mamarias, sendo considerado um tipo raro de tumor. Alguns dos tipos de LPM, por sua vez, possuem ligação intensa com o período gravídico e pós-parto em virtude do estimulo hormonal. O objetivo deste estudo e relatar um caso de LPM com apresentação rara de linfoma de Burkitt, considerando propostas terapêuticas eficazes para o seguimento. Relato do caso: Paciente do sexo feminino, 23 anos, portadora de tumoração periareolar em mama direita com aspecto de casca de laranja e crescimento rápido há um mês, queixas flogísticas no local da lesão, bom estado geral e sem outros sintomas associados. O quadro relatado iniciou-se sete meses após a expulsão fetal com feto morto. A paciente foi submetida a biopsia da lesão e encaminhada para seguimento ambulatorial sem sucesso, necessitando de retorno ao ambiente hospitalar por piora das condições clinicas e extensão da tumoração. Houve diagnostico de linfoma de Burkitt, com tratamento multidisciplinar, sendo submetida a protocolo CODOX-M de quimioterapia, com óbito após 22 dias de acompanhamento hospitalar. Conclusão: Este relato demonstra uma situação rara em uma paciente jovem, ressaltando a importância de investigar as alterações mamarias, de maneira eficaz, para um diagnóstico precoce correto e um tratamento adequado, em todas as faixas etárias.
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16
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Nguyen QD, Roberts JT. Unknown Case: 88-Year-Old Woman Presenting With a Breast Lump. JOURNAL OF BREAST IMAGING 2022; 4:96-98. [PMID: 38422420 DOI: 10.1093/jbi/wbab066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Indexed: 03/02/2024]
Affiliation(s)
- Quan D Nguyen
- Baylor College of Medicine, Department of Radiology, Houston, TX,USA
| | - James T Roberts
- University of Texas Medical Branch, Department of Radiology, Galveston, TX,USA
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17
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Huayanay Espinoza JL, Mego Ramírez FN, Guerra Miller H, Guelfguat M. An Overview of Rare Breast Neoplasms with Radiologic-Pathologic Correlation. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Primary breast CD20-positive extranodal NK/T cell lymphoma with stomach involvement: a case report and literature review. Diagn Pathol 2021; 16:103. [PMID: 34749754 PMCID: PMC8573996 DOI: 10.1186/s13000-021-01166-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/27/2021] [Indexed: 12/01/2022] Open
Abstract
Background We present a unique case of primary breast CD20-positive extranodal NK/T cell lymphoma with stomach involvement in a young Chinese female patient. Case presentation The patient presented with a mass in her right breast that rapidly increased in size over approximately 2 months. Upper gastrointestinal endoscopy showed a giant serpentine ulcer in the stomach. Biopsy was performed, and microscopic inspection revealed that the fibrous tissue was diffusely involved by medium to large abnormal lymphocytes. The cytoplasm was low to moderate. The tumor cells had irregular nuclei and inconspicuous nucleoli. The lymphoid cells were strongly immunoreactive to CD20, CD3, CD4, CD56, TIA-1, EBER, and Ki-67 (90%). Epstein-Barr virus genomes were also found in tumor cells by in situ hybridization. A whole-body positron emission tomography (PET)-CT scan revealed intense FDG uptake in the right breast and greater curvature of the stomach. Monoclonal rearrangements of the T cell receptor (TCR-γ) and immunoglobulin heavy chain (IgH) were identified by genetic analysis. Whole-genome next-generation sequencing was performed, and up to 12 gene mutations, including a frameshift mutation in exon 4 of the BCOR (G97Rfs*87; 44.3%) gene and a base substitution mutation (Q61H 17.6%) in exon 3 of the KRAS gene, were detected. Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed using the database for annotation, visualization, and integrated discovery, which showed that rare primary breast CD20-positive extranodal NK/T cell lymphoma had a unique genetic background compared with diffuse large B cell lymphoma and extranodal NK/T cell lymphoma without CD20 expression. The patient received four cycles of the modified SMILE regimen. The second whole-body PET-CT scan revealed that the right breast mass was significantly smaller than before; additionally, FDG uptake in the stomach wall disappeared. Conclusions Systemic examination, extensive immunohistochemistry, and molecular profiling are essential for an accurate diagnosis. More similar cases are required to clarify the biological pathways and even the potential molecular mechanisms of rare lymphomas, which may help direct further treatment.
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19
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ROCCO F, MASTROIANNI S, ALLOCCA A, PROCACCINI F, ALBACHIARA R, SCIARRA A, PROCACCINI E. Diffuse large B-cell lymphoma of the breast. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.20.05104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Chen M, Zhou J, Qu X. Primary Breast Diffuse Large B-Cell Lymphoma in a 42-Year-Old Female: A Case Report and Review of Literature. J Med Cases 2021; 12:181-185. [PMID: 34434454 PMCID: PMC8383536 DOI: 10.14740/jmc3660] [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: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 11/11/2022] Open
Abstract
Primary breast diffuse large B-cell lymphoma (PB-DLBCL) is a rare localized extranodal lymphoma. It is mainly diagnosed by pathological examination due to the lack of specific clinical and imaging manifestations. Whole-body positron emission tomography-computed tomography (PET-CT) is widely used in determining clinical staging and guiding clinical treatment. As part of comprehensive treatment, targeted therapy with rituximab, intrathecal methotrexate injection and consolidation radiotherapy remain controversial in treating PB-DLBCL, but the comprehensive treatment based on full-course of chemotherapy is still widely used as the first-line treatment. Comprehensive treatment often leads to a sharp decline in the immunity of elderly patients with malignancy. In this situation, surgery may be a good chance to improve their life quality without serious complications. We present a rare case of PB-DLBCL during the coronavirus disease 2019 (COVID-19) pandemic. The patient underwent chest CT scan to screen COVID-19 and a mass of left breast was accidentally found. Because of the city lockdown policy in Wuhan, she did not seek medical help until noticing that the mass was gradually enlarged. Both ultrasonography and mammography indicated that the lesion was breast cancer. However, ultrasound-guided core needle biopsy revealed diffuse large B-cell lymphoma of breast and PET-CT scan showed that the lesion was a primary hypermetabolic tumor of left breast. The patient subsequently received comprehensive treatment based on six cycles of rituximab-cyclophosphamide, hydroxydaunomycin, oncovin, prednisone (R-CHOP) chemotherapy.
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Affiliation(s)
- Maolin Chen
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Jun Zhou
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Xincai Qu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
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21
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Vaidya T, Ramani S, Rastogi A. A case series of metastases to the breast from extramammary malignancies. Indian J Radiol Imaging 2021; 28:470-475. [PMID: 30662213 PMCID: PMC6319108 DOI: 10.4103/ijri.ijri_218_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Metastases to the breast from extra-mammary malignancies are extremely uncommon. The discovery of a breast mass in a patient with a known primary tumor elsewhere poses a diagnostic challenge to the clinician. An awareness of the various malignancies that can metastasize to the breast and accurate diagnosis of the same is essential to avoid an unnecessary mastectomy and to guide further therapy. In this case series, we describe such clinical scenarios with an emphasis on the imaging features of metastases to the breast, which will enable radiologists to recognize this entity with greater ease.
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Affiliation(s)
- Tanvi Vaidya
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
| | - Subhash Ramani
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
| | - Ashita Rastogi
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Parel, Mumbai, India
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22
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Maurya V, Singh G, Ram B, Ganguli P. Multimodality imaging features of primary breast lymphoma - A rare entity. Indian J Radiol Imaging 2021; 29:85-88. [PMID: 31000948 PMCID: PMC6467037 DOI: 10.4103/ijri.ijri_344_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Primary lymphoma of breast is very rare which has no tell-tale imaging characteristics. Multimodality imaging helps not only in suggesting the possibility of lymphoma but also in its management. We present here one such case which was extensively worked up with various imaging modalities and was histologically proven as primary breast lymphoma.
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Affiliation(s)
- Vinay Maurya
- Department of Radiology, Command Hospital, Kolkata, West Bengal, India
| | - Giriraj Singh
- Department of Radiology, Command Hospital, Kolkata, West Bengal, India
| | - Birma Ram
- Department of Radiology, Command Hospital, Kolkata, West Bengal, India
| | - Prosenjit Ganguli
- Department of Pathology, Command Hospital, Kolkata, West Bengal, India
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23
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Metachronous Diffuse Large B-Cell Lymphoma of the Breasts: A Case Report and Review of the Literature. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.114180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Primary breast lymphoma (PBL) is a rare form of extranodal lymphoma. The most common pathology is diffuse large B cell lymphoma and most patients are diagnosed at stages 1 and 2. The therapeutic options available so far include surgery, radiotherapy, and chemotherapy Case Presentation: The patient was a 54-year old woman with localized primary breast diffuse large B-cell lymphoma (DLBCL). The patient underwent 6 courses of chemotherapy with an R-CHOP regimen followed by radiotherapy of the breast and regional lymph nodes with a dose of 40 Gy. In PET scan done three months later, the patient was in complete remission. Around one year later, the patient experienced relapse in the contralateral breast. Conclusions: In the pattern of lapse of patients, there is a tendency for extranodal relapse. In some studies it has been speculated that there is a high probability of relapse in central nervous system (CNS) and some authorities advocate CNS prophylaxis in these patients. The best outcome would be for patients treated with chemotherapy including rituximab followed by radiation. We reviewed some studies regarding treatment modalities and site of relapse.
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24
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Anagnostopoulou V, Mantha N, Sapalidis K, Tolparidou E, Georgiou E, Koletsa T. Male breast involvement in chronic lymphocytic leukemia. A case report and review of the literature. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:241-245. [PMID: 32747916 PMCID: PMC7728126 DOI: 10.47162/rjme.61.1.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Male breast lymphoma is a rare extranodal lymphoma occupying the mammary gland, and it could be either primary or secondary. A 78-year-old man presented an enlargement of the right breast. He had no medical history of interest. On physical examination, a unilateral, painless breast lump was found, with no skin changes or nipple discharge. There was no palpable lymphadenopathy. Routine laboratory tests revealed leukocytosis and lymphocytosis. Excisional biopsy of the breast lesion revealed mammary tissue infiltration by chronic lymphocytic leukemia (CLL) with plasmacytoid features and immunoglobulin G/kappa monotypic expression. To our knowledge, this is the first report of male breast involvement by CLL. Considering important the collection of clinicopathological data of all reported male breast lymphoma cases, a literature review is presented.
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25
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El Khoury M, Maietta A, Tran A, Trop I, Lalonde L, Mesurolle B. Case 285: Primary Breast Lymphoma. Radiology 2021; 298:231-236. [PMID: 33347397 DOI: 10.1148/radiol.2020191329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 25-year-old woman was referred to our breast clinic for assessment of a palpable mass in her left breast that developed quickly in 2 weeks. She denied any associated fever, chills, redness, or pain. She had no relevant medical or surgical history; no evidence of recent pregnancy, abortion, or breastfeeding; and no family history of breast cancer. Clinical examination enabled confirmation of a firm mass occupying the retroareolar region and the outer quadrant of the left breast with no skin retraction, edema, or erythema. There was no evidence of enlarged axillary lymph nodes. US of the left breast, bilateral breast MRI, and fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT were performed.
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Affiliation(s)
- Mona El Khoury
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Antonio Maietta
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Alphonse Tran
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Isabelle Trop
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Lucie Lalonde
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Benoît Mesurolle
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
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26
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Sereke SG, Oriekot A, Mboizi V, Bogere N, Bongomin F. T-cell non-Hodgkin's lymphoma of both breasts: An uncommon presentation of a common disease. Clin Case Rep 2021; 9:2400-2403. [PMID: 33936703 PMCID: PMC8077297 DOI: 10.1002/ccr3.4048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/09/2021] [Accepted: 02/27/2021] [Indexed: 11/05/2022] Open
Abstract
Secondary T-cell non-Hodgkin's lymphoma of the breasts is a very rare disease and can be easily missed as inflammatory carcinoma at initial presentation. High index of suspicion and radiological investigations has a big role in identifying the primary lymphoma.
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Affiliation(s)
- Senai Goitom Sereke
- Department of Radiology and RadiotherapySchool of MedicineMakerere University College of Health SciencesKampalaUganda
| | - Anthony Oriekot
- Department of Radiology and RadiotherapySchool of MedicineMakerere University College of Health SciencesKampalaUganda
| | - Vincent Mboizi
- Department of Radiology and RadiotherapySchool of MedicineMakerere University College of Health SciencesKampalaUganda
| | | | - Felix Bongomin
- Department of MedicineSchool of MedicineMakerere University College of Health SciencesKampalaUganda
- Department of Medical Microbiology and ImmunologyFaculty of MedicineGulu UniversityGuluUganda
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27
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Systemic diseases affecting the breast: Imaging, diagnosis, and management. Clin Imaging 2021; 77:76-85. [PMID: 33652268 DOI: 10.1016/j.clinimag.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 11/23/2022]
Abstract
Various systemic diseases of benign or malignant etiologies can clinically manifest in the breast. Some imaging findings of breast lesions can be pathognomonic for a given condition, while others are non-specific, mimicking primary breast carcinoma and requiring tissue biopsy for definitive diagnosis. In addition to obtaining a detailed clinical history, radiologists should be familiar with the diverse clinical and imaging characteristics of these conditions to help exclude primary breast cancer and avoid unnecessary interventions. This review aims to discuss the clinical presentations, imaging features, pathologic findings, and management of systemic conditions that may affect the breast.
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28
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Güven F, Demirci E, Demirci M, Yıldırım R. Primary high-grade diffuse large B-cell lymphoma of the breast. Br J Hosp Med (Lond) 2021; 82:1-4. [PMID: 33646037 DOI: 10.12968/hmed.2020.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fadime Güven
- Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Elif Demirci
- Department of Pathology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Munir Demirci
- Department of Nuclear Medicine, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Rahsan Yıldırım
- Department of Hematology and Oncology, School of Medicine, Ataturk University, Erzurum, Turkey
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29
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Leon A, Way AR, Sharma S, Letter H. It's Not Always Gynecomastia: A Case of Diffuse Large B-Cell Lymphoma Presenting as Breast Mass in a Male Patient. Cureus 2021; 13:e12944. [PMID: 33654621 PMCID: PMC7910194 DOI: 10.7759/cureus.12944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of diffuse large B-cell breast lymphoma that presented as a palpable breast lump in a male patient evaluated with digital mammography and targeted breast ultrasound (US) but ultimately confirmed by US-guided core needle biopsy. We will discuss the appropriate workup algorithm for a palpable breast lump in a male patient as outlined by the American College of Radiology (ACR) Appropriateness Criteria. While gynecomastia is the most common reason for a new palpable breast lump in a male patient, male breast cancer (including lymphoma and metastasis) can have a similar appearance on imaging. Our goal is to provide clarity on proper radiographic assessment protocols and imaging features of palpable breast masses in men by emphasizing the role of anatomical location and symmetry in distinguishing it from more common causes, such as gynecomastia, in future diagnostic imaging scenarios.
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Affiliation(s)
- Amie Leon
- Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Ashley R Way
- Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Smita Sharma
- Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Haley Letter
- Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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30
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Shahcheraghi S, Binesh F, Yazdi M, Kamal P, Mirhosseini S. Primary breast T-cell lymphoma. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2021. [DOI: 10.4103/mjdrdypu.mjdrdypu_374_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Ismail S, Kherbek H, Skef J, Naser Eldine M, Alshehabi Z. Primary marginal zone lymphoma of the breast; a rare case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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32
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Kobayashi H, Asada N, Igawa T, Abe M, Meguri Y, Ennishi D, Nishimori H, Fujii N, Matsuoka KI, Yoshino T, Maeda Y. Adult T-cell Leukemia-lymphoma with Primary Breast Involvement: A Case Report and Literature Review. Intern Med 2020; 59:2757-2761. [PMID: 32641657 PMCID: PMC7691018 DOI: 10.2169/internalmedicine.5077-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Breast involvement of Adult T-cell leukemia-lymphoma (ATLL) is extremely rare, and the data on the characteristics are limited. We herein describe a 49-year-old woman who presented with skin involvement of ATLL. Positron emission tomography/computed tomography showed bilateral breast lesions. Although the patient once achieved a complete metabolic response, a relapse of her ATLL occurred. The patient received subsequent allogeneic hematopoietic stem cell transplantation (HSCT). To our knowledge, only four cases of ATLL with breast involvement have previously been reported, and the prognoses have generally been poor. Breast lesions of ATLL have aggressive features, and intensive systemic chemotherapy and HSCT are required to improve survival.
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Affiliation(s)
- Hiroki Kobayashi
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Takuro Igawa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Masaya Abe
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Yusuke Meguri
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Nobuharu Fujii
- Department of Transfusion Medicine, Okayama University Hospital, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Japan
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Afridi F, Ruben GD, Oristian E. Case of Primary Breast and Ipsilateral Axillary T-Cell Lymphoma: a Rare Occurrence. Case Rep Surg 2020; 2020:6927835. [PMID: 33029443 PMCID: PMC7530482 DOI: 10.1155/2020/6927835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/14/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Malignant lymphomas of the breast are rare and can be primary or secondary. Non-Hodgkin Lymphoma involving the breast is even rarer comprising 0.04-0.5% of all breast malignancies (Takemura). The incidence is even lower for T-cell lymphomas compared with B-cell subtype. We report the rare incidence of primary T-cell lymphoma involving both breast and ipsilateral axilla. CASE This is the case of an 80-year-old female who initially presented with asymmetry of her right breast. Initial mammograms were inconclusive. MRI could not be performed due to the patient's severe claustrophobia. The patient was then lost to follow-up but re-presented with a new palpable density in the same breast. Subsequent mammogram showed a suspicious lesion with suspicious right axillary lymphadenopathy. Core biopsy was consistent with T-cell lymphoproliferative disorder involving both the breast and the axilla. She was then referred to medical oncology for management. CONCLUSION Although rare, lymphoproliferative disorders of the breast can be encountered during workup for suspicious breast lesions. It is imperative that the surgeon is aware of this rare diagnosis to facilitate appropriate therapeutic intervention.
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Affiliation(s)
- Faryal Afridi
- George Washington University Hospital Program, 900 23rd Street NW, Washington DC 20037, USA
| | - Garry D. Ruben
- Chief Department of General Surgery, Holy Cross Hospital, 1500 Forrest Glen Rd. Silver Spring MD 20910, USA
| | - Eric Oristian
- Chief Department of Breast Surgery, Holy Cross Hospital, 1500 Forrest Glen Rd. Silver Spring MD 20910, USA
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Gluskin J, D'Alessio D, Kim AC, Morris EA, Chiu A, Noy A. Primary lymphoma of the breast: A report of two cases. Clin Imaging 2020; 68:295-299. [PMID: 32961512 DOI: 10.1016/j.clinimag.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/06/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022]
Abstract
Primary breast lymphoma (PBL) should be distinguished from secondary breast lymphoma arising in the setting of lymphoma elsewhere in the body. Multimodality imaging is key to diagnosing PBL, and imaging manifestations thereof may indicate PBL and alter the treatment course. Treatment options including chemotherapy, radiation therapy, and/or surgery depend on histology. We report two cases of PBL, illustrating the transformative impact that multimodality imaging may have on clinical management.
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Affiliation(s)
- Jill Gluskin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Donna D'Alessio
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Andrew C Kim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - April Chiu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Ariela Noy
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
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Bletsis PP, Janssen LE, Visser O, Offerman SR, Tellier MA, Laterveer L, Houpt P. Bilateral breast implant associated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL): A case report. Int J Surg Case Rep 2020; 71:341-345. [PMID: 32497784 PMCID: PMC7267678 DOI: 10.1016/j.ijscr.2020.05.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION An estimated 30.000 breast implants are placed in the Netherlands annually. An increasing amount of reports have linked implants to the rare anaplastic large cell lymphoma (ALCL). Other implant-related lymphomas, such as those of B-cell lineage, are much rarer. PRESENTATION OF CASE A 62-year-old female presented with pain and Baker grade III capsular contraction of the right breast. Subpectorally placed textured anatomical implants had been in situ for 26 years after cosmetic augmentation. Magnetic Resonance Imaging (MRI) showed bilateral implant leakage. Explantation of both implants confirmed bilateral leakage after which symptoms went into remission. Three months later our patient noticed an erythematous area, scar swelling and serous fluid leakage on the lateral side of the inframammary fold of the right breast. Siliconomas were excised bilaterally together with a partial capsulectomy on the left. Histopathology and immunohistochemical analysis showed monotonous small cell B-lymphocytic infiltration (CD20+, CD5+, CD23+, ALK-) in both capsules, highly suggestive for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). DISCUSSION CLL/SLL are classified as nearly the same disease. The primary difference is the localization; CLL is found the bone marrow and blood whereas SLL is predominantly in the lymph nodes and spleen. There are no previous descriptions of bilateral CLL/SLL found in periprosthetic capsules. CONCLUSION Breast implants are increasingly linked to various malignancies. In most cases, including our patient, implant explantation together with long-term follow-up suffices. MRI yields additional value in early stage diagnosis. More research is required to further optimize multidisciplinary care and improve patient outcomes.
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Affiliation(s)
- Patrick P Bletsis
- Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands; Department of Plastic and Reconstructive Surgery, Isala Clinics, Zwolle, the Netherlands.
| | - Laura E Janssen
- Department of Plastic and Reconstructive Surgery, Isala Clinics, Zwolle, the Netherlands
| | - Otto Visser
- Department of Hematology, Isala Clinics, Zwolle, the Netherlands
| | | | - Michiel A Tellier
- Department of Plastic and Reconstructive Surgery, Isala Clinics, Zwolle, the Netherlands
| | | | - Peter Houpt
- Department of Plastic and Reconstructive Surgery, Isala Clinics, Zwolle, the Netherlands
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Tomita M, Oura S, Nishiguchi H, Makimoto S. A Case of Diffuse Large B Cell Lymphoma of the Breast with Predominantly High-Level Internal Echoes. Case Rep Oncol 2020; 13:309-313. [PMID: 32308597 PMCID: PMC7154268 DOI: 10.1159/000506676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
A 70-year-old woman had a large mass in her right breast. Mammography displayed focal asymmetrical density in the scattered areas of fibroglandular density. Ultrasonography showed the tumor to have predominantly high-level internal echoes. Histological examination showed that the tumor was composed of CD20-positive atypical cells with a large nucleus, scant cytoplasm, and abundant mitoses accompanied by a lot of fat cell interspersion and the diagnosis of diffuse large B cell lymphoma was made. We considered that the massive back scattering generated by the heterogeneity of acoustic impedance between fat cells and tumor cells brought about the high-level internal echoes. The patient had undergone chemotherapy followed by radiotherapy to the breast and regional nodes and has been well without lymphoma recurrence for more than 6 years. Although breast malignant lymphoma generally shows very low-level internal echoes, it could have high-level internal echoes especially in case of a non-dense breast.
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Affiliation(s)
- Masafumi Tomita
- Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-city, Japan
| | - Shoji Oura
- Division of Breast Surgery, Kishiwada Tokushukai Hospital, Kishiwada-city, Japan
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Chen VW, Hoang D, Clancy S. Breast Implant-Associated Bilateral B-Cell Lymphoma. Aesthet Surg J 2020; 40:NP52-NP58. [PMID: 29635460 DOI: 10.1093/asj/sjy093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Lymphomas associated with implants are predominantly of T-cell type-with anaplastic large cell lymphoma (ALCL) being most reported. That said, to date, 6 cases of B-cell lymphoma associated with breast implants have been reported. All cases exhibited unilateral breast involvement. Here, the authors report a case of low-grade B-cell lymphoma occurring bilaterally in a 34-year-old woman with a history of Poly Implant Prosthese silicone implants at age 20, T-cell angioimmunoblastic lymphoma, and subsequent myeloablative double cord blood transplantation. Lymphoma cells were positive for CD20, CD5, BCL-2, CD21, CD23, IgD, IgM, with very low Ki-67 of 1%. Nevertheless, cases of ALCL associated with breast implants are rare but much more documented in the literature than B-cell lymphomas associated with breast implants, as in this patient. Identification of a relationship between breast cancer and silicone is still ongoing in the literature, with long-term clinical follow up required. More research will be necessary to fully characterize the occurrence, course, and association of this disease with breast implants in order to properly guide diagnosis and management. LEVEL OF EVIDENCE: 5
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Affiliation(s)
- Vivi W Chen
- Department of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Don Hoang
- Department of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Sharon Clancy
- Department of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Rehman S, Naveed MA, Aleem J. Imaging Characteristics of Breast Lymphoma; a Case Series. JOURNAL OF CANCER & ALLIED SPECIALTIES 2020; 6:e305. [PMID: 37197145 PMCID: PMC10166316 DOI: 10.37029/jcas.v6i1.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 12/27/2019] [Indexed: 05/19/2023]
Abstract
Introduction 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. Materials and Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Sara Rehman
- Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Atif Naveed
- Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Javaria Aleem
- Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
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Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment. Case Rep Hematol 2019; 2019:9256807. [PMID: 31885957 PMCID: PMC6915144 DOI: 10.1155/2019/9256807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/09/2019] [Accepted: 11/18/2019] [Indexed: 11/24/2022] Open
Abstract
Extranodal Hodgkin lymphoma involving the breast is infrequent. Most cases reported in the literature were diagnosed by histology after lumpectomy. We present a Hodgkin lymphoma mimicking inflammatory breast carcinoma in a 57-year-old woman. The diagnosis was performed by fine-needle aspiration (FNA) of the breast lesion and the axillary lymph nodes with rapid on-site evaluation followed by immunocytochemistry, and it was confirmed by histology. The patient after first-line chemotherapy developed relapse/refractory disease. Salvage chemotherapy regimens were applied with poor results and severe toxicity. Total remission was achieved with monotherapy of brentuximab vedotin, a novel anti-CD30-targeted antibody drug conjugate. This is a unique case of breast HL with misleading clinical presentation initially diagnosed by cytology. FNA as a minimally invasive diagnostic tool was crucial in avoiding unnecessary breast surgery and further delay of chemotherapy. It is also the first report highlighting the importance of this novel immunotherapy in the management of refractory Hodgkin lymphoma with breast involvement.
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40
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Zhou C, Lv K, Lin D, Yu Y, Xu M, Bu Y. Radiological analysis of breast lymphoma: Experiences from cases series studies. Medicine (Baltimore) 2019; 98:e18101. [PMID: 31770231 PMCID: PMC6890291 DOI: 10.1097/md.0000000000018101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/28/2019] [Accepted: 10/28/2019] [Indexed: 01/30/2023] Open
Abstract
This retrospective study aimed to improve the diagnostic accuracy of breast lymphoma (BL) by analyzing the findings of BL on mammography and magnetic resonance imaging (MRI).Fifteen patients with breast lymphoma (BL, Primary/Secondary: 13/2) were confirmed by pathology. The imaging findings of those patients were analyzed by 2 senior radiologists.BL commonly showed significant enhancement with penetrating vessels and septation in masses on dynamic contrast-enhanced MRI (DCE-MRI). Diffusion limitation of BL is more pronounced than breast cancer on diffusion weighted imaging.The study suggests that the penetrating vessels and diffusion restriction of lesions are helpful for the diagnosis and differential diagnosis of BL.
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Affiliation(s)
- Changyu Zhou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Kun Lv
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dongya Lin
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yinxing Yu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yangyang Bu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
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Picasso R, Tagliafico A, Calabrese M, Martinoli C, Pistoia F, Rossi A, Zaottini F, Derchi L. Primary and Secondary Breast Lymphoma: Focus on Epidemiology and Imaging Features. Pathol Oncol Res 2019; 26:1483-1488. [PMID: 31428995 DOI: 10.1007/s12253-019-00730-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/14/2019] [Indexed: 12/01/2022]
Abstract
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 images 7 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.
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Affiliation(s)
- Riccardo Picasso
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Alberto Tagliafico
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Massimo Calabrese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Breast Radiology, Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10-16132, Genoa, Italy
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Pistoia
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Rossi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Zaottini
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lorenzo Derchi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Raj SD, Shurafa M, Shah Z, Raj KM, Fishman MDC, Dialani VM. Primary and Secondary Breast Lymphoma: Clinical, Pathologic, and Multimodality Imaging Review. Radiographics 2019; 39:610-625. [DOI: 10.1148/rg.2019180097] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Sean D. Raj
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
| | - Mahmud Shurafa
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
| | - Zeeshan Shah
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
| | - Karuna M. Raj
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
| | - Michael D. C. Fishman
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
| | - Vandana M. Dialani
- From the Department of Radiology, Baylor University Medical Center, American Radiology Associates, 712 N Washington Ave, Dallas, TX 75246 (S.D.R., M.S., Z.S.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (K.M.R.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (M.D.C.F., V.M.D.)
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Primary extranodal lymphoma of the glands. Literature review and options for best practice in 2019. Crit Rev Oncol Hematol 2019; 135:8-19. [PMID: 30819450 DOI: 10.1016/j.critrevonc.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 12/04/2018] [Accepted: 01/15/2019] [Indexed: 01/01/2023] Open
Abstract
Primary extranodal non-Hodgkin's lymphomas (EN-NHL) are a heterogeneous group of malignancies that involve numerous entities with significant difference in terms of tumor site locations, prognostic factors, biology expression, and therapeutic options. In the literature, many EN-NHL types were reported from limited series which only allowed narrow views for elucidating prognostic factors and defining the role of loco-regional therapies in the era of new systemic and biologically targeted therapies. The Rare Cancer Network (RCN), an international multidisciplinary consortium, has published a number of reports on several EN-NHL sites which included many gland locations. In this review, we will focus on the recent literature for a selected number of EN-NHL types in both exocrine and endocrine gland locations. We aim to provide renewed and clear messages for the best practice in 2019 for diagnosis, histopathology, treatments, and also their prognostic implications. We believe that better understanding of molecular and genetic characteristics of these particular diseases is crucial for an appropriate management in the era of personalized treatment developments.
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A Case Series of Breast Metastases from Different Extramammary Malignancies and Their Literature Review. Case Rep Radiol 2019; 2019:9454201. [PMID: 30729058 PMCID: PMC6341250 DOI: 10.1155/2019/9454201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/21/2018] [Accepted: 12/23/2018] [Indexed: 12/19/2022] Open
Abstract
Metastasis to the breast from all other primary sites is unusual. Twelve patients were diagnosed between 2007 and 2017 at National Cancer Institute, Mexico. Solitary or multiple masses, round or oval, and hypoechoic and solid lesions with posterior acoustic shadowing were patterns commonly reported in these patients; other arrangements include diffuse involvement of the breast simulating an inflammatory carcinoma. The development of a breast metastasis is revealed, in our experience, as a negative prognostic factor. Thus, the radiologist should know about the varied appearance of metastatic breast lesions and provide radiopathological correlations when available.
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45
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Melo A, Silva S, Ferreira C, Pereira R, Esteves A, Abreu Marques R, Moreira H, Avelar P. Primary breast lymphoma: A mimic of inflammatory breast cancer. Int J Surg Case Rep 2018; 53:410-413. [PMID: 30567057 PMCID: PMC6260440 DOI: 10.1016/j.ijscr.2018.11.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 11/26/2022] Open
Abstract
Primary breast lymphoma (PBL) is a rare disease accounting for 0.04–0.5% of all breast malignancies. The clinical and imaging findings in breast lymphoma can mimic those of breast carcinoma. Sometimes, PBL presentation is suggestive of Inflammatory breast cancer. Diagnosis depends on adequate tissue sampling for histology examination and immunophenotyping. The therapeutic management of PBL is controversial and is not clearly established, but many studies support that it is not a surgical disease and can be treated successfully with combined chemotherapy and radiotherapy. Imaging is a useful method to monitor a patient’s response to therapy.
Introduction Primary breast lymphoma (PBL) is a rare disease accounting for 0.04–0.5% of all breast malignancies. Presentation of case This article reports a clinical case of a 81-year-old woman with a history of right breast erythema and edema associated to breast pain, with over two weeks duration. Physical examination demonstrated mammary asymmetry and inflammatory signs with orange peel skin. She had the right upper limb swollen and palpable axillar and supraclavicular lymph nodes. The principal suspicion was an inflammatory breast cancer. Imaging was unspecific. Core needle biopsy of an axillary lymph node and of the breast mass identified morphological and immunophenotypic features consistent with diagnosis of primary non-Hodgkin DLBCL. Patient was guided by Hematology. Discussion The clinical and imaging findings in breast lymphoma can mimic those of breast carcinoma. Sometimes, PBL presentation is suggestive of Inflammatory breast cancer. Diagnosis depends on adequate tissue sampling for histology examination and immunophenotyping. The therapeutic management of PBL is controversial and is not clearly established, but many studies support that it is not a surgical disease and can be treated successfully with combined chemotherapy and radiotherapy. Conclusion Breast lymphoma must be considered in the differential diagnosis of a breast lump, even in the presence of cutaneous inflammatory changes. PBL can be treated successfully with combined therapy.
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Affiliation(s)
- Ana Melo
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Sílvia Silva
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Cátia Ferreira
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Ricardo Pereira
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Ana Esteves
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Rita Abreu Marques
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Herculano Moreira
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
| | - Paulo Avelar
- Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.
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Matsumoto RAEK, Catani JH, Campoy ML, Oliveira AM, de Barros N. Radiological findings of breast involvement in benign and malignant systemic diseases. Radiol Bras 2018; 51:328-333. [PMID: 30369661 PMCID: PMC6198842 DOI: 10.1590/0100-3984.2016.0125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although the primary purpose of periodic mammograms in screening programs is to
identify lesions suspected of being carcinomas, the findings are often related
to systemic (benign or malignant) diseases, rather than breast cancer. Although
the involvement of breast structures in systemic diseases is unusual, it can be
included in the differential diagnosis of masses, skin changes, calcifications,
asymmetry, and axillary lymphadenopathy. The main diagnostic entities that can
be associated with such involvement are diabetes, chronic kidney disease, heart
diseases, connective tissue diseases, HIV infection, lymphoma, leukemia, and
metastases from primary tumors at other sites. In many cases, information
related to knowledge and treatment of chronic diseases is not available to the
radiologist at the time of evaluation of the mammography findings. The purpose
of this essay is to offer relevant pictorial information to the general
radiologist about systemic diseases involving the breast, expanding the range of
differential diagnoses in order to avoid unnecessary invasive procedures.
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Affiliation(s)
| | - Juliana Hiraoka Catani
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | | | - Arthur Magalhães Oliveira
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Nestor de Barros
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
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47
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Clinico-radiologic features and management of hematological tumors in the breast: a case series. Breast Cancer 2018; 26:244-248. [PMID: 30229499 DOI: 10.1007/s12282-018-0906-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
Hematological tumors arising in the breast are uncommon and require different treatment modalities dependent upon tumor type. Current treatment options include surgical excision, chemotherapy, and radiotherapy. Management of these breast malignancies are poorly outlined in the literature. The purpose of this case series is to report five cases consisting of extranodal marginal zone lymphoma, lymphoplasmacytic lymphoma, and extramedullary plasmacytoma occurring in the breast. The cases illustrate heterogeneous radiologic findings and varying management approaches to these tumors. The case series underscores the importance of having a wide differential at diagnosis and recognizes management of disease should be taken on an individual basis with consideration of prognosis and first-line treatment options.
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48
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Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ. Breast Lesions in Children and Adolescents: Diagnosis and Management. Korean J Radiol 2018; 19:978-991. [PMID: 30174488 PMCID: PMC6082765 DOI: 10.3348/kjr.2018.19.5.978] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/04/2018] [Indexed: 11/15/2022] Open
Abstract
Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.
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Affiliation(s)
- Eun Ji Lee
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Jung Hee Oh
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Hyun-Joo Kim
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
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49
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Wienbeck S, Meyer HJ, Surov A. [Imaging findings of intramammary malignant lymphoproliferative disease]. Radiologe 2018; 58:929-934. [PMID: 29992401 DOI: 10.1007/s00117-018-0428-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Intramammary manifestation of lymphoproliferative disease is rare. The radiological evaluation follows in most cases the clinical suspicion and therefore the radiologist takes an important place in diagnostics. The aim of this work is to demonstrate typical radiological patterns of this rare entity with multimodal cases and to sensitize for it. The differential diagnosis to other breast tumors, especially primary breast carcinoma, can be radiologically difficult, so the suspicious lesion must be histologically verified by biopsy.
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Affiliation(s)
- S Wienbeck
- Institut für Diagnostische und Interventionelle Radiologie, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
| | - H J Meyer
- Institut für Diagnostische und Interventionelle Radiologie, Universität Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - A Surov
- Institut für Diagnostische und Interventionelle Radiologie, Universität Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.,Institut für Radiologie, Universität Halle, Ernst-Grube-Str. 40, 06120, Halle, Deutschland
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50
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Wadhwa A, Senebouttarath K. Primary lymphoma of the breast: A case series. Radiol Case Rep 2018; 13:815-821. [PMID: 29988973 PMCID: PMC6034137 DOI: 10.1016/j.radcr.2018.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/04/2018] [Indexed: 01/05/2023] Open
Abstract
Primary breast lymphoma has been defined as localized involvement of one or both breasts with or without ipsilateral axillary nodal involvement, usually as a rare manifestation of extranodal non-Hodgkin's lymphoma. We describe three cases of this uncommon disease seen at our institution. Two of these cases presented as palpable breast lumps and one was screening detected. None of the patients had a prior history of lymphoma; only one reported B symptoms night sweats and weight loss. Diagnosis was established on ultrasound-guided core biopsy and no evidence of metastatic disease was identified. Even though the imaging features are not specific to this diagnosis, the radiologists should be aware of the clinical and imaging presentation of this rare malignancy to recommend appropriate management and establish radiologic–pathologic concordance.
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Affiliation(s)
- Anubha Wadhwa
- Department of Radiology, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States
| | - Kathleen Senebouttarath
- Department of Radiology, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States
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