Limits...
Primary breast peripheral T-cell lymphoma not otherwise specified: report of a case.

Muroya D, Toh U, Iwakuma N, Nakagawa S, Mishima M, Takahashi R, Takenaka M, Shirouzu K, Agaki Y - Surg. Today (2014)

Bottom Line: Malignant lymphomas of the breast are rare and primary breast lymphoma comprises <0.5 % of breast malignancies, within which T-cell lymphomas are an even rarer subset.We report a case of primary breast peripheral T-cell lymphoma not otherwise specified (PTCL-NOS).To our knowledge, only 18 cases of primary peripheral T-cell lymphoma of the breast and just one previous case of primary PTCL-NOS of the breast have been reported in Japan.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Kurume Faculty of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.

ABSTRACT
Malignant lymphomas of the breast are rare and primary breast lymphoma comprises <0.5 % of breast malignancies, within which T-cell lymphomas are an even rarer subset. We report a case of primary breast peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). Histology of the biopsied specimen revealed CD2(+), CD3(+), CD4(+), CD5(-), CD7(+), CD8(-), CD20(-), CD25(-), CD30(+), CD56(-), bcl-2(-), EBV-ISH(-), TIA-I(-), and ATLA negative. The patient was treated with six cycles of the CHOP regimen and died 17 months after the diagnosis was made, despite complete remission after conventional chemotherapy. To our knowledge, only 18 cases of primary peripheral T-cell lymphoma of the breast and just one previous case of primary PTCL-NOS of the breast have been reported in Japan.

Show MeSH

Related in: MedlinePlus

a Mammogram findings. The craniocaudal and mediolateral oblique (MLO) view revealed no mass lesion or other abnormality in the bilateral breasts. b Ultrasonography findings. An irregular, round and solid hypoechoic nodule in the 11:00 o’clock position corresponds to a nodule palpated on clinical examination
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4264879&req=5

Fig1: a Mammogram findings. The craniocaudal and mediolateral oblique (MLO) view revealed no mass lesion or other abnormality in the bilateral breasts. b Ultrasonography findings. An irregular, round and solid hypoechoic nodule in the 11:00 o’clock position corresponds to a nodule palpated on clinical examination

Mentions: A 77-year-old woman presented to a city hospital with the chief complaint of a painless, palpable mass in the right breast; however, the results of fine needle aspiration cytology were inconclusive. One month later, computer tomography (CT) showed bilateral pleural effusions and she was moved to our university hospital. Routine physical examination revealed a 1.5-cm diameter, round mass in the upper outer quadrant of her right breast. A heterogenic mass was seen on ultrasonography (Fig. 1b), but nothing was seen on a diagnostic mammogram (Fig. 1a). Her medical history included a 15-year history of hypertension, well controlled with medication. Results of a staging chest X-ray film, a complete blood count, and liver function tests were normal, except for a high IL-2R of 1803 U/ml. Magnetic resonance imaging (MRI) revealed a 2.2-cm diameter mass in the right breast, showing a malignant imaging pattern in dynamic study, but no metastasis in the bilateral axillary lymph nodes (Fig. 2). Scintigraphy also showed increased gallium uptake in the left submandibular gland. Subsequent ultrasound-guided biopsy demonstrated atypical lymphocytes containing medium to large round nucleoli. Histologic analysis of the biopsy specimen was consistent with a peripheral T-cell lymphoma not otherwise specified and microscopic pathology revealed atypical lymphocytes containing medium to large round nucleoli and irregular nuclear shapes (Fig. 3a). Immunohistochemistry revealed CD2(+), CD3(+) (Fig. 3b), CD4(+), CD5(−), CD7(+), CD8(−), CD20(−) (Fig. 3c), CD25(−), CD30(+), CD56(−), bcl-2(−), EBV-ISH(−), TIA-I(−), and ATLA negative. Simultaneously, a 2.5-cm diameter mass was found in the left mandibular area. Fine needle aspiration was performed by an otolaryngologist and cytological examination revealed a malignant lymphoma with the features of PTCL-NOS. Although there was no evidence of metastasis in specimens of bone marrow biopsy, the cytology of the pleural effusion had shown the same involvement of malignant lymphoma. Even without associated lymph node involvement, we diagnosed Stage IV PTCL-NOS with three extralymphatic organs; namely the breast, mandibular gland, and pleural effusion, prior to the chemotherapy. On re-evaluating her initial breast MRI, the CT scan had shown the breast mass progressing rapidly with a significant increase in tumor size and in the pleural effusions (Fig. 4a) before treatment.Fig. 1


Primary breast peripheral T-cell lymphoma not otherwise specified: report of a case.

Muroya D, Toh U, Iwakuma N, Nakagawa S, Mishima M, Takahashi R, Takenaka M, Shirouzu K, Agaki Y - Surg. Today (2014)

a Mammogram findings. The craniocaudal and mediolateral oblique (MLO) view revealed no mass lesion or other abnormality in the bilateral breasts. b Ultrasonography findings. An irregular, round and solid hypoechoic nodule in the 11:00 o’clock position corresponds to a nodule palpated on clinical examination
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4264879&req=5

Fig1: a Mammogram findings. The craniocaudal and mediolateral oblique (MLO) view revealed no mass lesion or other abnormality in the bilateral breasts. b Ultrasonography findings. An irregular, round and solid hypoechoic nodule in the 11:00 o’clock position corresponds to a nodule palpated on clinical examination
Mentions: A 77-year-old woman presented to a city hospital with the chief complaint of a painless, palpable mass in the right breast; however, the results of fine needle aspiration cytology were inconclusive. One month later, computer tomography (CT) showed bilateral pleural effusions and she was moved to our university hospital. Routine physical examination revealed a 1.5-cm diameter, round mass in the upper outer quadrant of her right breast. A heterogenic mass was seen on ultrasonography (Fig. 1b), but nothing was seen on a diagnostic mammogram (Fig. 1a). Her medical history included a 15-year history of hypertension, well controlled with medication. Results of a staging chest X-ray film, a complete blood count, and liver function tests were normal, except for a high IL-2R of 1803 U/ml. Magnetic resonance imaging (MRI) revealed a 2.2-cm diameter mass in the right breast, showing a malignant imaging pattern in dynamic study, but no metastasis in the bilateral axillary lymph nodes (Fig. 2). Scintigraphy also showed increased gallium uptake in the left submandibular gland. Subsequent ultrasound-guided biopsy demonstrated atypical lymphocytes containing medium to large round nucleoli. Histologic analysis of the biopsy specimen was consistent with a peripheral T-cell lymphoma not otherwise specified and microscopic pathology revealed atypical lymphocytes containing medium to large round nucleoli and irregular nuclear shapes (Fig. 3a). Immunohistochemistry revealed CD2(+), CD3(+) (Fig. 3b), CD4(+), CD5(−), CD7(+), CD8(−), CD20(−) (Fig. 3c), CD25(−), CD30(+), CD56(−), bcl-2(−), EBV-ISH(−), TIA-I(−), and ATLA negative. Simultaneously, a 2.5-cm diameter mass was found in the left mandibular area. Fine needle aspiration was performed by an otolaryngologist and cytological examination revealed a malignant lymphoma with the features of PTCL-NOS. Although there was no evidence of metastasis in specimens of bone marrow biopsy, the cytology of the pleural effusion had shown the same involvement of malignant lymphoma. Even without associated lymph node involvement, we diagnosed Stage IV PTCL-NOS with three extralymphatic organs; namely the breast, mandibular gland, and pleural effusion, prior to the chemotherapy. On re-evaluating her initial breast MRI, the CT scan had shown the breast mass progressing rapidly with a significant increase in tumor size and in the pleural effusions (Fig. 4a) before treatment.Fig. 1

Bottom Line: Malignant lymphomas of the breast are rare and primary breast lymphoma comprises <0.5 % of breast malignancies, within which T-cell lymphomas are an even rarer subset.We report a case of primary breast peripheral T-cell lymphoma not otherwise specified (PTCL-NOS).To our knowledge, only 18 cases of primary peripheral T-cell lymphoma of the breast and just one previous case of primary PTCL-NOS of the breast have been reported in Japan.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Kurume Faculty of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.

ABSTRACT
Malignant lymphomas of the breast are rare and primary breast lymphoma comprises <0.5 % of breast malignancies, within which T-cell lymphomas are an even rarer subset. We report a case of primary breast peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). Histology of the biopsied specimen revealed CD2(+), CD3(+), CD4(+), CD5(-), CD7(+), CD8(-), CD20(-), CD25(-), CD30(+), CD56(-), bcl-2(-), EBV-ISH(-), TIA-I(-), and ATLA negative. The patient was treated with six cycles of the CHOP regimen and died 17 months after the diagnosis was made, despite complete remission after conventional chemotherapy. To our knowledge, only 18 cases of primary peripheral T-cell lymphoma of the breast and just one previous case of primary PTCL-NOS of the breast have been reported in Japan.

Show MeSH
Related in: MedlinePlus