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Primary malignant non-Hodgkin's lymphoma of the breast: A case report.

Zhao YF, Jiao F, Liang HQ, Luo QC, Zhao LW - Oncol Lett (2014)

Bottom Line: A diagnosis of diffuse large B-cell lymphoma was determined as a result of histological and immunohistochemical profile analysis.At present, the patient is scheduled for regular follow-up appointments.As the prevalence of PLB is increasing, the details of this rare case may aid clinicians treating similar patients, and highlight the importance of this disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China.

ABSTRACT
Primary malignant lymphoma of the breast (PLB) is a rare disease. Treatment options include surgical resection, systemic chemotherapy, radiation and immunotherapy. At present, the optimum treatment combination remains controversial. The present study reports the case of a 39-year-old female with a six month history of a painless mass in the left breast. The mass was excised following medical examination. A diagnosis of diffuse large B-cell lymphoma was determined as a result of histological and immunohistochemical profile analysis. Further examinations excluded metastatic disease. Thus, finally, PLB (diffuse large B-cell lymphoma type) was diagnosed. The patient was treated with adjuvant systemic chemotherapy and consolidated radiation and a positive response was observed. During the 10 months of follow-up, no evidence of disease recurrence was identified. At present, the patient is scheduled for regular follow-up appointments. As the prevalence of PLB is increasing, the details of this rare case may aid clinicians treating similar patients, and highlight the importance of this disease.

No MeSH data available.


Related in: MedlinePlus

Histological examination results confirmed a malignant lymphoma. The diffuse infiltration of numerous of neoplastic lymphocytes was identified (hematoxylin-eosin stain; magnification, ×100).
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f2-ol-08-06-2597: Histological examination results confirmed a malignant lymphoma. The diffuse infiltration of numerous of neoplastic lymphocytes was identified (hematoxylin-eosin stain; magnification, ×100).

Mentions: In April 2013, a 39-year-old female presented to the Department of Surgery, Suining Central Hospital (Suining, China) with a six month history of a painless mass in the left breast. The mass had rapidly increased in size over six months. No history of other diseases was identified. On physical examination, a nontender, demarcated firm 5.0×5.0 cm elastic mass with an irregular surface, was palpable in the upper inner quadrant of the left breast. The right breast was normal. Enlargement of the axillary lymph nodes was not identified. On ultrasonography, the mass was observed to be solid, almost entirely hyperechoic, and exhibited a circumscribed margin in the palpable area. Digital radiographic examination revealed a mass of 5.0×4.0×4.0 cm with an increased density shadow (Fig. 1). The radiological results were assessed prospectively according to the American College of Radiology Breast Imaging-Reporting and Data System (10,11) as category 3 or 4 (suspicion for malignancy). An ultrasound guided core needle biopsy of the left breast was performed. The histological results revealed the infiltration of a large number of lymphocytes into the breast lobular and duct and lymphocyte hyperplastic lesions were suspected. Thus, mass excision was performed and a definitive diagnosis was established. Grossly, the 5.0×5.0×4.0 cm tumor was gray-white and poorly circumscribed. Microscopically, the tumor cells demonstrated invasive growth and a tendency to surround and invade the wall and lumina of the epithelial structures, resulting in a lymphoepithelial lesion. In addition, the mammary gland structure was destroyed. Numerous neoplastic lymphocytes revealed a diffuse growth pattern (Fig. 2). The examination results revealed malignant lymphoma and thus, further immunophenotype analysis was required to determine the type of lymphoma. The immunohistochemical profile was positive for cluster of differentiation (CD)20 and CD79a and negative for CD3, myeloperoxidase, terminal deoxynucleotidyl transferase, CD99 and CD138 (Fig. 3). In addition, the Ki67 positive rate was 60% (Fig. 3). The results confirmed the diagnosis of a diffuse large B-cell lymphoma. Additionally, the patient underwent further examination to exclude metastatic disease using positron emission tomography/computed tomography, which revealed no evidence of further disease. Thus, primary NHL of the breast (diffuse large B-cell lymphoma type) was diagnosed. The patient was treated with six cycles of combination chemotherapy [intravenous cyclophosphamide (750 mg/m2, day 1), intravenous doxorubicin (50 mg/m2, day 1), intravenous vincristine (1.4 mg/m2, day 1 and 8) and prednisone (80 mg, daus 1–5)] for six months. Following three cycles of chemotherapy, radiation was adminstered to the local site (40 Gy), in combination with chemotherapy for an additional three cycles. The patient exhibited a positive response with no evidence of disease. During the follow-up period of 10 months, no symptoms or signs of disease recurrence were observed. At present, the patient is receiving regular follow-up.


Primary malignant non-Hodgkin's lymphoma of the breast: A case report.

Zhao YF, Jiao F, Liang HQ, Luo QC, Zhao LW - Oncol Lett (2014)

Histological examination results confirmed a malignant lymphoma. The diffuse infiltration of numerous of neoplastic lymphocytes was identified (hematoxylin-eosin stain; magnification, ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214428&req=5

f2-ol-08-06-2597: Histological examination results confirmed a malignant lymphoma. The diffuse infiltration of numerous of neoplastic lymphocytes was identified (hematoxylin-eosin stain; magnification, ×100).
Mentions: In April 2013, a 39-year-old female presented to the Department of Surgery, Suining Central Hospital (Suining, China) with a six month history of a painless mass in the left breast. The mass had rapidly increased in size over six months. No history of other diseases was identified. On physical examination, a nontender, demarcated firm 5.0×5.0 cm elastic mass with an irregular surface, was palpable in the upper inner quadrant of the left breast. The right breast was normal. Enlargement of the axillary lymph nodes was not identified. On ultrasonography, the mass was observed to be solid, almost entirely hyperechoic, and exhibited a circumscribed margin in the palpable area. Digital radiographic examination revealed a mass of 5.0×4.0×4.0 cm with an increased density shadow (Fig. 1). The radiological results were assessed prospectively according to the American College of Radiology Breast Imaging-Reporting and Data System (10,11) as category 3 or 4 (suspicion for malignancy). An ultrasound guided core needle biopsy of the left breast was performed. The histological results revealed the infiltration of a large number of lymphocytes into the breast lobular and duct and lymphocyte hyperplastic lesions were suspected. Thus, mass excision was performed and a definitive diagnosis was established. Grossly, the 5.0×5.0×4.0 cm tumor was gray-white and poorly circumscribed. Microscopically, the tumor cells demonstrated invasive growth and a tendency to surround and invade the wall and lumina of the epithelial structures, resulting in a lymphoepithelial lesion. In addition, the mammary gland structure was destroyed. Numerous neoplastic lymphocytes revealed a diffuse growth pattern (Fig. 2). The examination results revealed malignant lymphoma and thus, further immunophenotype analysis was required to determine the type of lymphoma. The immunohistochemical profile was positive for cluster of differentiation (CD)20 and CD79a and negative for CD3, myeloperoxidase, terminal deoxynucleotidyl transferase, CD99 and CD138 (Fig. 3). In addition, the Ki67 positive rate was 60% (Fig. 3). The results confirmed the diagnosis of a diffuse large B-cell lymphoma. Additionally, the patient underwent further examination to exclude metastatic disease using positron emission tomography/computed tomography, which revealed no evidence of further disease. Thus, primary NHL of the breast (diffuse large B-cell lymphoma type) was diagnosed. The patient was treated with six cycles of combination chemotherapy [intravenous cyclophosphamide (750 mg/m2, day 1), intravenous doxorubicin (50 mg/m2, day 1), intravenous vincristine (1.4 mg/m2, day 1 and 8) and prednisone (80 mg, daus 1–5)] for six months. Following three cycles of chemotherapy, radiation was adminstered to the local site (40 Gy), in combination with chemotherapy for an additional three cycles. The patient exhibited a positive response with no evidence of disease. During the follow-up period of 10 months, no symptoms or signs of disease recurrence were observed. At present, the patient is receiving regular follow-up.

Bottom Line: A diagnosis of diffuse large B-cell lymphoma was determined as a result of histological and immunohistochemical profile analysis.At present, the patient is scheduled for regular follow-up appointments.As the prevalence of PLB is increasing, the details of this rare case may aid clinicians treating similar patients, and highlight the importance of this disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China.

ABSTRACT
Primary malignant lymphoma of the breast (PLB) is a rare disease. Treatment options include surgical resection, systemic chemotherapy, radiation and immunotherapy. At present, the optimum treatment combination remains controversial. The present study reports the case of a 39-year-old female with a six month history of a painless mass in the left breast. The mass was excised following medical examination. A diagnosis of diffuse large B-cell lymphoma was determined as a result of histological and immunohistochemical profile analysis. Further examinations excluded metastatic disease. Thus, finally, PLB (diffuse large B-cell lymphoma type) was diagnosed. The patient was treated with adjuvant systemic chemotherapy and consolidated radiation and a positive response was observed. During the 10 months of follow-up, no evidence of disease recurrence was identified. At present, the patient is scheduled for regular follow-up appointments. As the prevalence of PLB is increasing, the details of this rare case may aid clinicians treating similar patients, and highlight the importance of this disease.

No MeSH data available.


Related in: MedlinePlus