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Parra-Medina R, Rocha F, Castañeda-González JP, Moreno-Lucero P, Veloza L, Romero-Rojas AE. Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports. Medicine (Baltimore) 2022; 101:e28988. [PMID: 35838994 PMCID: PMC11132339 DOI: 10.1097/md.0000000000028988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The presence of a lymphoma associated with a solid synchronous neoplasm or collision neoplasm has been rarely in the literature, and a detailed characterization of these cases is lacking to date. OBJECTIVE To describe the main clinicopathological features of synchronous/collision tumors. METHODS A systematic search in PubMed, Scielo, and Virtual Health Library literature databases for cases or case series of synchronous or collision lymphoma and other solid neoplasms reported up to March 2021 was performed. Three reviewers independently screened the literature, extracted data, and assessed the quality of the included studies. The systematic review was performed following the Preferred Reporting Items for Systematic Meta-Analyses guidelines. RESULTS Mean age of patients was 62.9 years (52.9% men). A total of 308 cases were included (62% synchronous and 38% collision). The most frequent location of both synchronous and collision tumors was the gastrointestinal tract with the most common solid neoplasm being adenocarcinoma, and the most frequent lymphoma diffuse large B-cell lymphoma (21.7%) and mucosa-associated lymphoid tissue lymphoma (20.4%). Of the total number of mucosa-associated lymphoid tissue lymphomas and gastric adenocarcinomas, the presence of Helicobacter pylori infection was documented in 47.3% of them. Only 2% of all cases had a previous history of lymphoma. Thus, in most cases (98%), lymphoma was discovery incidentally. In addition, nodal lymphoma was associated with metastasis in 29 (9.4%) cases as collision tumor, most commonly (90%) in locoregional lymph nodes of the solid neoplasm. CONCLUSIONS The frequent association of some type of B-cell lymphoma and adenocarcinoma in synchronous/collision tumors of the gastrointestinal tract points to common pathogenic mechanisms in both neoplasia, particularly related to chronic inflammation in this location. In most cases, lymphoma identified in locoregional lymph nodes or distant of a carcinoma seems to represent an incidental finding during the carcinoma diagnostic/therapeutic approach. A synergy between carcinoma and lymphoma (involving inflammation and immunosuppression mechanisms) may favor tumor progression and dissemination. A better understating of the interactions lymphoma/carcinoma in the setting of synchronous/collision tumors may help to improve patient management and prognosis.
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Affiliation(s)
- Rafael Parra-Medina
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
- Research Institute, Fundación Universtaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Franky Rocha
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | | | - Paula Moreno-Lucero
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | - Luis Veloza
- Institute of Pathology, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
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2
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Grove J, Komforti MK, Craig-Owens L, Beuerlein F. A Collision Tumor in the Breast Consisting of Invasive Ductal Carcinoma and Malignant Melanoma. Cureus 2022; 14:e23588. [PMID: 35494985 PMCID: PMC9045959 DOI: 10.7759/cureus.23588] [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] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Collision tumors are rare neoplasms that consist of at least two different cell lineages at the same site. Given the many possible combinations that can occur, collision tumors, while rare, have been reported in multiple locations such as the stomach, bladder, and thyroid. Collision tumors are rarely found in breast tissue, with only a few cases reported in the literature. We herein report a unique case of a 79-year-old woman with a history of melanoma who presented with a left breast mass that was subsequently found to have invasive ductal carcinoma (IDC) and metastatic melanoma in the breast tissue. This is one of the first reported combinations of these two malignancies.
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3
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Chen X, Chen J, Liao S, Cao Y. Invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia manifesting as a collision breast tumor: A case report and literature review. Open Life Sci 2021; 16:867-871. [PMID: 34522780 PMCID: PMC8402943 DOI: 10.1515/biol-2021-0093] [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: 05/18/2021] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Collision breast tumors, consisting of breast cancer (BC) and non-Hodgkin’s lymphoma (NHL), are extremely rare. Here we report the case of a 64-year-old woman with a collision tumor in her left breast mass that was composed of invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia. In addition, we reviewed the published comparable English-language literature. Collision breast tumor composed of BC and NHL is extremely rare. For that reason, there is a lack of consensus about the underlying mechanism, and diagnosing it without delay remains a complex clinical challenge. We found that post-menopausal, age-related estrogen levels changes and Epstein-Barr virus infection are possible pathogenic factors. However, the symptoms are almost identical, and it is difficult to distinguish a simple breast tumor from a breast collision tumor. In this study, we reviewed the clinical features of all patients with BC and NHL colliding breast tumors; this information might enable early identification and prevention of misdiagnosis.
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Affiliation(s)
- Xiaowen Chen
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jianli Chen
- The Third Department of Medical Oncology, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Sihai Liao
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yuwen Cao
- Department of Pathology, Shihezi University School of Medicine, Shihezi, Xinjiang, China
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4
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Pancreatic Collision Tumor of Ductal Adenocarcinoma and Neuroendocrine Tumor. ACG Case Rep J 2018; 5:e39. [PMID: 29850646 PMCID: PMC5968152 DOI: 10.14309/crj.2018.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/28/2018] [Indexed: 01/13/2023] Open
Abstract
A pancreatic collision tumor is a rare entity that can be challenging to diagnose. We present a very rare case of a pancreatic collision tumor composed of both a neuroendocrine tumor and a ductal adenocarcinoma. Preoperative diagnosis was clinically challenging because both the radiology and fine-needle biopsy were consistent with a typical neuroendocrine mass. However, gross examination of the mass postoperatively revealed neuroendocrine cells with rare foci of ductal adenocarcinoma without a transition zone. Awareness of this entity is important so that medical practitioners consider pursuing surgical management of pancreatic lesions that otherwise would be managed exclusively with surveillance.
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5
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Synchronous ipsilateral carcinoma of the accessory mammary gland and primary lymphoma of the breast with subsequent rectal carcinoma: report of a case. World J Surg Oncol 2014; 12:286. [PMID: 25217973 PMCID: PMC4247717 DOI: 10.1186/1477-7819-12-286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/02/2014] [Indexed: 11/10/2022] Open
Abstract
A case of synchronous carcinoma of the accessory mammary gland and primary breast lymphoma with subsequent rectal carcinoma has not been reported previously. We present a very rare case of primary non-Hodgkin lymphoma of the left breast diagnosed simultaneously with invasive lobular carcinoma of the left axillary accessory mammary gland and rectal adenocarcinoma. An 82-year-old Japanese woman presented with two palpable masses on the left chest wall. She was given a diagnosis of suspected breast malignant tumor and axillary accessory mammary gland. She underwent excision of the axillary accessory mammary gland and left mastectomy with axillary lymph node dissection. Histopathological examination revealed diffuse large B-cell lymphoma of the breast and invasive lobular carcinoma of the axillary accessory mammary gland with lymph nodes metastasis. Three months after the surgery, primary rectal adenocarcinoma was also detected by F-18 fluorodeoxyglucose positron emission tomography. Hartmann’s operation was performed, since which time the patient has been doing well.
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6
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Ho CWG, Mantoo S, Lim CH, Wong CY. Synchronous invasive ductal carcinoma and intravascular large B-cell lymphoma of the breast: a case report and review of the literature. World J Surg Oncol 2014; 12:88. [PMID: 24708809 PMCID: PMC3985532 DOI: 10.1186/1477-7819-12-88] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 03/30/2014] [Indexed: 12/14/2022] Open
Abstract
Primary breast lymphomas (PBLs) represent less than 1% of all breast malignancies. Intravascular large B-cell lymphoma (ILBCL) is a rare, aggressive form of extranodal lymphoma. Breast involvement has only been described in the literature once previously. ILBCL is characterized by the proliferation of tumour cells within the lumen of small vessels of involved organs, resulting in their eventual occlusion. Clinical features are often vague, diagnosis is difficult and delayed, and prognosis is usually poor. We report the first ever case of synchronous ILBCL and invasive ductal carcinoma (IDC) of the breast in a patient presenting with pyrexia of unknown origin and altered mental status who underwent modified radical mastectomy and subsequent chemotherapy, and review the literature regarding intravascular large B-cell lymphoma, PBLs and synchronous carcinomas and lymphomas of the breast.
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Affiliation(s)
- Christopher Wei Guang Ho
- Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
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7
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Tamaoki M, Nio Y, Tsuboi K, Nio M, Tamaoki M, Maruyama R. A rare case of non-invasive ductal carcinoma of the breast coexisting with follicular lymphoma: A case report with a review of the literature. Oncol Lett 2014; 7:1001-1006. [PMID: 24944658 PMCID: PMC3961434 DOI: 10.3892/ol.2014.1885] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 01/15/2014] [Indexed: 11/18/2022] Open
Abstract
The double presentation of breast cancer and follicular lymphoma is extremely rare, and only six cases have previously been reported in the literature. In the present study, a case of synchronous ductal carcinoma in situ (DCIS) of the breast and follicular lymphoma is reported. During an annual breast screening procedure, a 49-year-old female presented with a hard induration under the nipple of the right breast and swelling of a soft lymph node (LN) in the right axilla. Mammography and ultrasonography revealed two lesions in the right breast: One was a tumor with microcalcification, 1.0 cm in diameter, and the other was a large, crude calcification, 2.5 cm in diameter. In addition, computed tomography and positron emission tomography revealed swellings of the bilateral axillary (Ax) LN and intra-abdominal para-aortic LN. The patient underwent excisions of the large calcified mass, a micro-calcified tumor and the right AxLN. The pathological and immunohistochemical studies revealed fat necrosis and DCIS of the breast, which was positive for the estrogen receptor and the progesterone receptor, while human epidermal growth factor receptor II protein expression was evaluated as 2+ and stage was classified as pTis pN0 M0, stage 0. Furthermore, the Ax node was diagnosed as follicular lymphoma, which was positive for cluster of differentiation (CD)20, CD79a, CD10 and B-cell lymphoma (Bcl)-2 protein, but negative for Bcl-6 protein. The clinical stage was classified as stage III. The patient was administered chemotherapy followed by radiotherapy to the conserved breast. Two years have passed since the surgery, and the patient is disease-free.
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Affiliation(s)
| | | | | | | | | | - Riruke Maruyama
- Department of Pathology, Faculty of Medicine, Shimane University, Izumo, Japan
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8
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Shin YD, Lee SK, Kim KS, Park MJ, Kim JH, Yim HS, Choi YJ. Collision tumor with inflammatory breast carcinoma and malignant phyllodes tumor: a case report and literature review. World J Surg Oncol 2014; 12:5. [PMID: 24400686 PMCID: PMC3895737 DOI: 10.1186/1477-7819-12-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 12/25/2013] [Indexed: 11/12/2022] Open
Abstract
There have been some reports of coincidental presentation of breast carcinoma and phyllodes tumor in the same breast. Most of the cases were carcinoma that arose from a phyllodes tumor with a histologically identified transitional area, and they behaved less aggressively than the usually encountered carcinoma. Collision tumors are rare clinical entities in which two histologically distinct tumor types show involvement at the same site. The occurrence of these tumors in the breast is extremely rare. Here, we report a case of 45-year-old woman who had both invasive ductal carcinoma as the finding of inflammatory carcinoma and a malignant phyllodes tumor in the same breast. There was no evidence of a transitional area between the phyllodes tumor and the invasive ductal carcinoma. To our knowledge, this is the first report of a collision tumor of inflammatory breast carcinoma coincident with a malignant phyllodes tumor in same breast.
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Affiliation(s)
| | | | | | | | | | | | - Young Jin Choi
- Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Dunsan-dong 1306, Seo-gu, Daejeon 135-710, Korea.
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9
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Synchronous bilateral breast carcinoma and axillary non-hodgkin lymphoma: a case report and review of the literature. Case Rep Oncol Med 2012; 2012:685919. [PMID: 23050177 PMCID: PMC3461627 DOI: 10.1155/2012/685919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/29/2012] [Indexed: 11/21/2022] Open
Abstract
The use of staging imaging modalities with increased sensitivity has led to an increase in the incidence of detection of simultaneous malignancies. These cases require careful evaluation and discussion in a multidisciplinary setting to establish a treatment plan that optimizes the outcome with respect to each malignancy, particularly when treatment modalities overlap. We report a case of a patient diagnosed with axillary nodal diffuse large B-cell lymphoma (DLBCL) in a community hospital where staging workup also revealed synchronous bilateral breast carcinomas. To our knowledge, this is only the second case report of a patient with three synchronous primary malignancies: bilateral breast carcinomas and axillary DLBCL. The only other similar case report had no role for radiation or chemotherapy in the management of the indolent follicular lymphoma.
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10
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Intramammary lymph nodes: A question seeking for an answer or an answer seeking for a question? Breast 2012; 21:615-20. [DOI: 10.1016/j.breast.2012.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 05/30/2012] [Accepted: 06/07/2012] [Indexed: 11/21/2022] Open
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11
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Chronic lymphocytic leukemia mimicking recurrent carcinoma of the breast: Case report and review of the literature. Pathol Res Pract 2011; 207:514-7. [DOI: 10.1016/j.prp.2011.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 04/13/2011] [Accepted: 05/12/2011] [Indexed: 11/23/2022]
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12
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Anavekar NS, Rozen WM, Rowe K, Murphy C. Synchronous carcinoma and lymphoma of the breast. Clin Breast Cancer 2008; 8:281-4. [PMID: 18650160 DOI: 10.3816/cbc.2008.n.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary breast lymphoma is a rare entity. Furthermore, extranodal marginal zone B-cell lymphoma affecting the breast is exceedingly rare. We report a unique case of invasive lobular carcinoma diagnosed simultaneously with an extranodal marginal zone B-cell lymphoma of the breast. A literature review demonstrated 2 reports of synchronous invasive ductal carcinoma and mucosa-associated lymphoid tissue lymphoma affecting the breast; however, there is a paucity of cases demonstrating different malignancies affecting the same breast tissue in a particular patient, especially in the setting of lobular carcinoma. As such, there are no clear guidelines on the optimal management of such synchronous tumors. Herein, the diagnostic and management issues are explored.
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13
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Abstract
A 51-year-old woman presented with a 2-month history of double vision and numbness around her left ear. She subsequently became unsteady on her feet and developed further cranial nerve abnormalities, before complaining of headache, nausea and vomiting. Imaging revealed features suggestive of two intracranial lesions; one non-contrast-enhancing high-signal area in the cerebellum with associated calcification, and a second contrast-enhancing low-signal area in association with the fourth ventricle, and at surgery there were two apparent components to the tumor. The histopathological features were those of a low-grade, focally calcified tumor comprising atypical ganglion and glial cells with interspersed Rosenthal fibres. Mitotic figures were not seen, and there was no necrosis. An infiltrate of small reactive lymphocytes was interspersed among the neoplastic cells. Immunohistochemistry revealed expression of synaptophysin by many of the dysplastic ganglion cells, with some co-expressing neurofilament protein and occasionally glial fibrillary acidic protein (GFAP). Several of the dysplastic ganglion cells also expressed CD34. The glial cell population was highlighted by GFAP. Ki-67 (MIB-1) activity was not noted among the neoplastic populations--the few positive nuclei in these areas were those of interspersed reactive CD3-positive T lymphocytes. In addition, at the edge of one of the biopsies was a dense infiltrate of mitotically-active large atypical CD 20-positive B lymphocytes, among which the Ki-67 (MIB-1) labeling index reached 80%. The final diagnosis was diffuse large B cell lymphoma arising within a ganglioglioma of the cerebellum, and this is believed to be the first reported case.
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14
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Wada DA, Agarwal N, Florell SR, Lim MS. Recurrent squamous cell carcinoma and follicular lymphoma arising in the scalp after treatment for lymphoma. Pathology 2008; 40:316-20. [PMID: 18428060 DOI: 10.1080/00313020701813602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Rajendran RR, Palazzo JP, Schwartz GF, Glick JH, Solin LJ. Primary Mucosa-Associated Lymphoid Tissue Lymphoma of the Breast. Clin Breast Cancer 2008; 8:187-8. [DOI: 10.3816/cbc.2008.n.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Cheung KJ, Tam W, Chuang E, Osborne MP. Concurrent Invasive Ductal Carcinoma and Chronic Lymphocytic Leukemia Manifesting as a Collision Tumor in Breast. Breast J 2007; 13:413-7. [PMID: 17593048 DOI: 10.1111/j.1524-4741.2007.00451.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Collision tumors are rare clinical entities in which two histologically distinct tumor types show involvement in the same site. The occurrence of these tumors in the breast is extremely rare. Here, we present a case of a patient with both invasive ductal carcinoma and chronic lymphocytic leukemia in the breast. Wide excision with sentinel lymph node biopsy revealed palpably abnormal lymph nodes negative for breast carcinoma on frozen section. Histopathological examination of these lymph nodes showed extensive involvement by lymphoma and review of the breast specimen demonstrated the same lymphoma at the periphery of the ductal carcinoma. We review the literature and discuss possible etiologies for the dual presentation of both cancers.
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MESH Headings
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Chemotherapy, Adjuvant
- Female
- Humans
- Immunohistochemistry
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/radiotherapy
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Lymphoma/pathology
- Middle Aged
- Neoplasm Invasiveness
- Neoplasms, Multiple Primary/pathology
- Sentinel Lymph Node Biopsy
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Affiliation(s)
- Kevin J Cheung
- Department of Surgery, New York-Weill Cornell Medical Center, New York, New York 10021, USA
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17
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Barroeta JE, Farkas T. Merkel cell carcinoma and chronic lymphocytic leukemia (collision tumor) of the arm: a diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol 2007; 35:293-5. [PMID: 17427219 DOI: 10.1002/dc.20616] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Simultaneous involvement of the same anatomical site by two different primary malignant tumors is rare. Cases of hematopoietic malignancies associated with breast and skin neoplasms have been described. The association of chronic lymphocytic leukemia (CLL) and Merkel cell carcinoma (MCC) has been established, although the cause for this association is still unclear. There are reports of MCC metastatic to lymph nodes involved by CLL. We report the case of a 57-year-old man with history of CLL with concurrent involvement of the arm by CLL and MCC diagnosed on fine-needle aspiration biopsy (FNA). To our knowledge, this is the first reported case of such tumors colliding in a nonlymphoid site, diagnosed by FNA in the English literature.
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Affiliation(s)
- Julieta E Barroeta
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA
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18
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Taeda Y, Ariga N, Okamura K, Takei N, Komeno T, Ueki H, Ohtani H. Primary Breast mucosa-associated lymphoid tissue (malt) lymphoma with high-grade transformation evidenced by prominent lymphoepithelial lesions. Breast Cancer 2006; 13:322-327. [PMID: 16929129 DOI: 10.2325/jbcs.13.322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Primary breast lymphoma, particularly primary mucosa-associated lymphoid tissue (MALT) lymphoma, is a rare disease. We report here a case of a MALT lymphoma of the breast with high-grade transformation. An 84-year-old woman presented with a Pagetoid mass in her right breast. After a clinical diagnosis of breast cancer, T2N1M0, stage II B, she underwent mastectomy with axillary lymph node dissection. She had no history of autoimmune disease such as Hashimoto thyroiditis or Sjögren disease. Pathologically the tumor tissue was composed of small to large lymphoid cells. The large cells contained a considerable number of centroblasts, forming a sheet-like proliferation centrally. Among the small cells many small cleaved cells were present, which were more predominant in the peripheral areas. Immunohistochemistry revealed that these cells were positive for CD20 and CD79a. The tumor cells infiltrated the ductular epithelial cells, distorting the duct structures, to form lymphoepithelial lesions. Immunohistochemistry for cytokeratin and CD20 was helpful for identification. No germinal centers were formed. MALT lymphoma with high-grade transformation was diagnosed. Rituximab (anti-CD20 antibody) was prescribed as systemic treatment without chemotherapy or irradiation. After 18 months, no tumor recurrence was observed. We emphasize the importance of lymphoepithelial lesions for the diagnosis of MALT lymphoma of the breast.
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MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD20/metabolism
- Antineoplastic Agents/therapeutic use
- Breast Neoplasms/complications
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Cell Transformation, Neoplastic
- Epithelial Cells/pathology
- Female
- Humans
- Lymphoid Tissue/pathology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Mastectomy
- Rituximab
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Affiliation(s)
- Yoshinori Taeda
- Departments of Surgery, National Hospital Organization, Japan
| | - Naohiro Ariga
- Departments of Surgery, National Hospital Organization, Japan
| | - Kayoko Okamura
- Departments of Surgery, National Hospital Organization, Japan
| | - Naoko Takei
- Departments of Hematology, National Hospital Organization, Japan
| | - Takuya Komeno
- Departments of Hematology, National Hospital Organization, Japan
| | - Hamaiti Ueki
- Departments of Surgery, National Hospital Organization, Japan
| | - Haruo Ohtani
- Departments of Pathology, Mito Medical Center, National Hospital Organization, Japan
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19
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Wiernik PH, Etkind PR. Is Mouse Mammary Tumor Virus an Etiologic Agent of Human Breast Cancer and Lymphoma? South Med J 2006; 99:108-10. [PMID: 16509544 DOI: 10.1097/01.smj.0000198260.49203.0f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Quilon JM, Gaskin TA, Ludwig AS, Alley C. Collision Tumor: Invasive Ductal Carcinoma in Association with Mucosa-associated Lymphoid Tissue (MALT) Lymphoma in the Same Breast. South Med J 2006; 99:164-7. [PMID: 16509555 DOI: 10.1097/01.smj.0000198640.58397.c5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Synchronous occurrence of multiple neoplastic processes is uncommon and the relationship between breast cancer with lymphoproliferative diseases is unusual as well. Furthermore, breast involvement by malignant lymphoma is a rare event and primary breast mucosa-associated lymphoid tissue (MALT) lymphoma is even rarer. We report a patient with synchronous occurrence of malignant lymphoma of MALT type and ductal carcinoma of the breast, presenting as "collision tumor," invading each other and occurring as a single mass in the breast. Involvement of the sentinel lymph node by MALT lymphoma was demonstrated with no evidence of metastatic carcinoma. Staging bone marrow biopsy did not show involvement by malignant lymphoma or carcinoma. Our patient was treated with chemotherapy for the lymphoma. She also received radiotherapy and aromatase inhibitor as adjuvant therapy for the breast carcinoma.
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MESH Headings
- Biopsy
- Bone Marrow/pathology
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Diagnosis, Differential
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Mastectomy
- Middle Aged
- Neoplasm Invasiveness
- Neoplasms, Multiple Primary
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21
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Cox J, Lunt L, Webb L. Synchronous presentation of breast carcinoma and lymphoma in the axillary nodes. Breast 2005; 15:246-52. [PMID: 16188443 DOI: 10.1016/j.breast.2005.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Revised: 05/23/2005] [Accepted: 06/23/2005] [Indexed: 02/07/2023] Open
Abstract
We report the first series of cases in the literature of three female patients with a synchronous presentation of breast carcinoma with coincidental axillary lymphoma. Aspects of each case are described and learning points for clinician discussed.
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MESH Headings
- Axilla
- Breast Neoplasms/complications
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/complications
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Diagnosis, Differential
- Female
- Humans
- Lymph Nodes/diagnostic imaging
- Lymph Nodes/pathology
- Lymphoma/complications
- Lymphoma/diagnosis
- Lymphoma/diagnostic imaging
- Lymphoma/pathology
- Mammography
- Middle Aged
- Neoplasms, Multiple Primary/complications
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/pathology
- Tomography, X-Ray Computed
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Affiliation(s)
- Julie Cox
- Breast Screening Unit, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK.
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