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Secondary breast lymphoma diagnosed by vacuum-assisted breast biopsy: a case report.

Zagouri F, Sergentanis TN, Nonni A, Koulocheri D, Domeyer P, Dardamanis D, Michalopoulos NV, Pararas N, Gounaris A, Zografos GC - J Med Case Rep (2007)

Bottom Line: VABB yielded enough tissue for immunohistochemistry/WHO classification.It should be stressed that VABB was able to yield enough tissue for WHO classification.In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Breast Unit, 1st Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens; 114, Vas Sofias Ave, Athens 116 27, Greece. gzografo@med.uoa.gr.

ABSTRACT

Introduction: Breast lymphoma, either as a manifestation of primary extranodal disease or as secondary involvement, is a rare malignancy, and its diagnosis, prognosis, and treatment have not been clearly defined. On the other hand, Vacuum-assisted breast biopsy (VABB) is a minimally invasive technique with ever-growing use for the diagnosis of mammographically detected, non-palpable breast lesions.

Case presentation: A symptom-free, 56-year-old woman presented with a non-palpable BI-RADS 4B lesion without microcalcifications. She had a positive family history for breast cancer and a history of atypical ductal hyperplasia in the ipsilateral breast four years ago. She reported having been treated for non-Hodgkin lymphoma 12 years ago. With the suspicion of breast cancer, mammographically guided VABB with 11-gauge probe (on the stereotactic Fisher's table) was performed. VABB made the diagnosis of a non-Hodgkin, grade II, B-cell germinal-center lymphoma. VABB yielded enough tissue for immunohistochemistry/WHO classification.

Conclusion: This is the first case in the literature demonstrating the successful diagnosis of breast lymphoma by VABB, irrespectively of the level of clinical suspicion. It should be stressed that VABB was able to yield enough tissue for WHO classification. In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.

No MeSH data available.


Related in: MedlinePlus

The suspicious lesion on the screen (Fischer workstation, VABB device).
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Figure 1: The suspicious lesion on the screen (Fischer workstation, VABB device).

Mentions: The radiologist of our Unit characterized the suspicious lesion as BI-RADS 4B (lesion with an intermediate suspicion of malignancy) and a VABB was scheduled. Lymphoma was not suspected at presentation. VABB was performed on a digital prone table (Mammotest, Fischer Imaging, Denver, CO, USA) using 11-gauge Mammotome vacuum probes, under local anesthesia (Figures 1, 2). Using one main target-offset and one offset inside the solid lesion, 24 cores were excised from the suspicious lesion (Figures 1, 2, 3). The length of the cores varied between 0.5 and 2.8 cm. A clip marker was placed after biopsy and a mammogram to the affected breast confirmed the excision of cores in the lesion.


Secondary breast lymphoma diagnosed by vacuum-assisted breast biopsy: a case report.

Zagouri F, Sergentanis TN, Nonni A, Koulocheri D, Domeyer P, Dardamanis D, Michalopoulos NV, Pararas N, Gounaris A, Zografos GC - J Med Case Rep (2007)

The suspicious lesion on the screen (Fischer workstation, VABB device).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2169247&req=5

Figure 1: The suspicious lesion on the screen (Fischer workstation, VABB device).
Mentions: The radiologist of our Unit characterized the suspicious lesion as BI-RADS 4B (lesion with an intermediate suspicion of malignancy) and a VABB was scheduled. Lymphoma was not suspected at presentation. VABB was performed on a digital prone table (Mammotest, Fischer Imaging, Denver, CO, USA) using 11-gauge Mammotome vacuum probes, under local anesthesia (Figures 1, 2). Using one main target-offset and one offset inside the solid lesion, 24 cores were excised from the suspicious lesion (Figures 1, 2, 3). The length of the cores varied between 0.5 and 2.8 cm. A clip marker was placed after biopsy and a mammogram to the affected breast confirmed the excision of cores in the lesion.

Bottom Line: VABB yielded enough tissue for immunohistochemistry/WHO classification.It should be stressed that VABB was able to yield enough tissue for WHO classification.In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Breast Unit, 1st Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens; 114, Vas Sofias Ave, Athens 116 27, Greece. gzografo@med.uoa.gr.

ABSTRACT

Introduction: Breast lymphoma, either as a manifestation of primary extranodal disease or as secondary involvement, is a rare malignancy, and its diagnosis, prognosis, and treatment have not been clearly defined. On the other hand, Vacuum-assisted breast biopsy (VABB) is a minimally invasive technique with ever-growing use for the diagnosis of mammographically detected, non-palpable breast lesions.

Case presentation: A symptom-free, 56-year-old woman presented with a non-palpable BI-RADS 4B lesion without microcalcifications. She had a positive family history for breast cancer and a history of atypical ductal hyperplasia in the ipsilateral breast four years ago. She reported having been treated for non-Hodgkin lymphoma 12 years ago. With the suspicion of breast cancer, mammographically guided VABB with 11-gauge probe (on the stereotactic Fisher's table) was performed. VABB made the diagnosis of a non-Hodgkin, grade II, B-cell germinal-center lymphoma. VABB yielded enough tissue for immunohistochemistry/WHO classification.

Conclusion: This is the first case in the literature demonstrating the successful diagnosis of breast lymphoma by VABB, irrespectively of the level of clinical suspicion. It should be stressed that VABB was able to yield enough tissue for WHO classification. In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.

No MeSH data available.


Related in: MedlinePlus