Synchronous breast cancer and breast lymphoma are rare. It is of high rate of misdiagnosis in clinical practice. Here we present two cases with this presentation. They are both middle-aged women, with stage I invasive...Synchronous breast cancer and breast lymphoma are rare. It is of high rate of misdiagnosis in clinical practice. Here we present two cases with this presentation. They are both middle-aged women, with stage I invasive ductal carcinoma of the breast. One patient happened to have primary breast lymphoma （PBL）; the other was secondary breast lymphoma （SBL）. Their pathology and immunohistochemistry （IHC） findings supported the diagnosis of multiple primary carcinoma. Both patients had a surgery. Then they both received CHOP regime chemotherapy and subsequent endocrine therapy.展开更多
Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the abse...Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracycline-based chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history;nulliparous;followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration;a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy;the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.展开更多
Introduction: Breast involvement by non-Hodgkin lymphoma is particularly rare in women. We describe the case of a patient with a rapidly growing, nodule in the right breast. On ultrasonography, the nodule was suspicio...Introduction: Breast involvement by non-Hodgkin lymphoma is particularly rare in women. We describe the case of a patient with a rapidly growing, nodule in the right breast. On ultrasonography, the nodule was suspicious for breast carcinoma. Case presentation: A breast biopsy from a 73-year-old Moroccan women answered invasive ductal carcinoma grade 3 from Elston and Ellis. Patey was performed. Microscopic examination showed lymphoid proliferation confirmed on immunohistochemical analysis. Our patient was treated with chemotherapy. Conclusions: The rarity of breast lymphomas, and the problems related to the diagnosis and therapeutic choices with these tumors require molecular techniques in association with classical histological diagnosis.展开更多
BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challen...BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challenging because of its rarity,heterogeneity,and aggressive behavior.Conventional ultrasound(US)is the first-line imaging modality for breast lesions;however,it has limited specificity and accuracy for PB-DLBCL.Shear wave elastography(SWE)is a novel US technique that measures tissue stiffness and may reflect the histological characteristics and biological behavior of breast lesions.AIM To compare the conventional US and SWE features of PB-DLBCL and evaluate their diagnostic performance and prognostic value.METHODS We retrospectively reviewed the clinical data and US images of 32 patients with pathologically confirmed PB-DLBCL who underwent conventional US and SWE before treatment.We analyzed conventional US features(shape,margin,orientation,echo,posterior acoustic features,calcification,and vascularity)and SWE features(mean elasticity value,standard deviation,minimum elasticity value,maximum elasticity value,and lesion-to-fat ratio)of the PB-DLBCL lesions.Using receiver operating characteristic curve analysis,we determined the optimal cutoff values and diagnostic performance of conventional US and SWE features.We also performed a survival analysis to assess the prognostic value of conventional US and SWE features.RESULTS The results showed that the PB-DLBCL lesions were mostly irregular in shape(84.4%),microlobulated or spiculated in margins(75%),parallel in orientation(65.6%),hypoechoic in echo(87.5%),and had posterior acoustic enhancement(65.6%).Calcification was rare(6.3%)and vascularity was variable(31.3%avascular,37.5%hypovascular,and 31.3%hypervascular).The mean elasticity value of PB-DLBCL lesions was significantly higher than that of benign breast lesions(113.4±46.9 kPa vs 27.8±16.4 kPa,P<0.001).The optimal cutoff value of the mean elasticity for distinguishing PB-DLBCL from benign breast lesions was 54.5 kPa,with a sensitivity of 93.8%,specificity of 92.9%,positive predictive value of 93.8%,negative predictive value of 92.9%,and accuracy of 93.3%.The mean elasticity value was also significantly correlated with Ki-67 expression level(r=0.612,P<0.001),which is a marker of tumor proliferation and aggressiveness.Survival analysis showed that patients with higher mean elasticity values(>54.5 kPa)had worse overall survival(OS)and progression-free survival(PFS)than those with lower mean elasticity values(<54.5 kPa)(P=0.038 for OS and P=0.027 for PFS).CONCLUSION Conventional US and SWE provide useful information for diagnosing and forecasting PB-DLBCL.SWE excels in distinguishing PB-DLBCL from benign breast lesions,reflects tumor proliferation and aggressiveness,and improves disease management.展开更多
Pprimary breast lymphoma （PBL） is rare, accounting for 0.04%-0.50% of breast malignancies and 1.7% of extranodal lymphoma The originally descnibect diagnostic criteria for PBL2 remains the standard definition for th...Pprimary breast lymphoma （PBL） is rare, accounting for 0.04%-0.50% of breast malignancies and 1.7% of extranodal lymphoma The originally descnibect diagnostic criteria for PBL2 remains the standard definition for this disease. These criteria are breast location as the clinical site of presentation, absence of history of previous lymphoma or evidence of widespread disease at diagnosis, close association of lymphoma with breast tissue in pathologic specimens, and involvement of ipsilateral lymph nodes if they develop simultaneously with PBL.展开更多
Primary non-Hodgkin’s lymphomas is an uncommon disease representing approximately 0.13% of all reported malignant mammary neoplasms. Clinically they are mainly observed as solitary lesions, but may also be seen as mu...Primary non-Hodgkin’s lymphomas is an uncommon disease representing approximately 0.13% of all reported malignant mammary neoplasms. Clinically they are mainly observed as solitary lesions, but may also be seen as multiple foci. Herein, we present a very rare case with the diagnosis of multifocal malignant lymphoma of the breast. Case: A 56-year-old-female patient with a right palpable breast mass admitted to the hospital. Mammography and ultrasonography findings showed two different foci of hypoechoic solid mass forming lesion in the right breast. Excisional biopsy has been performed. In the histopathological evaluation, both lesions demonstrated foci of necrosis;mitotically active tumor cells with large nucleus and prominent nucleoli. The immunohistochemical analysis revealed diffuse LCA, CD20, CD43, focal CD68 positivity while pancytokeratin, EMA, CD34, SMA were negative. The case was diagnosed as Diffuse Large B-cell Lymphoma. We report a very rare case with a diagnosis of multifocal primary non-Hodgkin’s lymphoma of the breast.展开更多
<strong>Background: </strong>Breast lymphomas are typical extranodal types of lymphoma, also known as Extranodal-lymphoma (ENL), which occur extremely infrequently, aggregating into a very small proportion...<strong>Background: </strong>Breast lymphomas are typical extranodal types of lymphoma, also known as Extranodal-lymphoma (ENL), which occur extremely infrequently, aggregating into a very small proportion of malignant breast tumors. The rarity of breast lymphomas is attributed to the scant lymphoid tissue content of the chest wall. <strong>Aims of Study: </strong>This case report is aimed at providing an up-to-date review of the literature on breast lymphomas for clinicians to, therefore, consider the possibility of this disease entity while treating a breast mass. <strong>Case Presentation:</strong> A case was reported of a 52-year man with chief mammary non-Hodgkin breast ENL when fine-needle aspiration cytology (FNAC) was not leading to a firm conclusion or result. Following an incisional biopsy, he was found to have a primary breast lymphoma. Later, the patient was diagnosed with the diffuse large B-cell type of lymphoma also known as non-Hodgkin’s Lymphoma (NHL). He had a complete reduction and disappearances of all the signs and symptoms of the disease after a course of neoadjuvant chemotherapy: Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone (CHOP). <strong>CONCLUSION: </strong>Based on the above case presentation, it is vital for health care professionals and oncologists to recognize the disease by assessing the breast mass accurately with more entities so that proper diagnosis via core biopsy (incisional biopsy) can eliminate the PBL before further treatment is required.展开更多
目的探讨乳腺淋巴瘤(breast lymphoma,BL)的临床病理学特征、诊断及鉴别诊断。方法收集72例BL的临床病理资料,采用免疫组化EnVision两步法染色,应用FISH法检测C-myc、BCL-2、BCL-6基因扩增及断裂重排情况;应用BIOMED-2 PCR检测T/B细胞...目的探讨乳腺淋巴瘤(breast lymphoma,BL)的临床病理学特征、诊断及鉴别诊断。方法收集72例BL的临床病理资料,采用免疫组化EnVision两步法染色,应用FISH法检测C-myc、BCL-2、BCL-6基因扩增及断裂重排情况;应用BIOMED-2 PCR检测T/B细胞基因重排;运用原位杂交法检测EBER,分析其与临床病理特征的关系。结果72例BL中女性69例,男性3例;发病年龄24~83岁,中位年龄55岁。BL影像学特征具有非特异性,与乳腺癌的临床表现相似;72例BL中弥漫大B细胞淋巴瘤(diffused large B cell lymphoma,DLBCL)52例,结外黏膜相关淋巴组织边缘区淋巴瘤(extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue,MALT)7例,T淋巴母细胞性淋巴瘤(T lymphoblastic lymphoma,T-LBL)6例,其余少见类型为7例。52例DLBCL经原位杂交检测EBER均阴性,FISH检测2例有BCL-6基因断裂。16例患者具有完整临床病理资料,原发性乳腺淋巴瘤(primary breast lymphoma,PBL)12例,继发性乳腺淋巴瘤(secondary breast lymphoma,SBL)4例,两组患者预后均较差,差异无统计学意义(P>0.05)。结论BL的病理类型以DLBCL为主,男性患者罕见。BL通过影像学鉴别难度较大,主要通过穿刺活检病理诊断;PBL和SBL的临床病理特征及预后,差异无统计学意义。展开更多
文摘Synchronous breast cancer and breast lymphoma are rare. It is of high rate of misdiagnosis in clinical practice. Here we present two cases with this presentation. They are both middle-aged women, with stage I invasive ductal carcinoma of the breast. One patient happened to have primary breast lymphoma （PBL）; the other was secondary breast lymphoma （SBL）. Their pathology and immunohistochemistry （IHC） findings supported the diagnosis of multiple primary carcinoma. Both patients had a surgery. Then they both received CHOP regime chemotherapy and subsequent endocrine therapy.
文摘Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracycline-based chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history;nulliparous;followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration;a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy;the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.
文摘Introduction: Breast involvement by non-Hodgkin lymphoma is particularly rare in women. We describe the case of a patient with a rapidly growing, nodule in the right breast. On ultrasonography, the nodule was suspicious for breast carcinoma. Case presentation: A breast biopsy from a 73-year-old Moroccan women answered invasive ductal carcinoma grade 3 from Elston and Ellis. Patey was performed. Microscopic examination showed lymphoid proliferation confirmed on immunohistochemical analysis. Our patient was treated with chemotherapy. Conclusions: The rarity of breast lymphomas, and the problems related to the diagnosis and therapeutic choices with these tumors require molecular techniques in association with classical histological diagnosis.
基金This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Guizhou Medical University.
文摘BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challenging because of its rarity,heterogeneity,and aggressive behavior.Conventional ultrasound(US)is the first-line imaging modality for breast lesions;however,it has limited specificity and accuracy for PB-DLBCL.Shear wave elastography(SWE)is a novel US technique that measures tissue stiffness and may reflect the histological characteristics and biological behavior of breast lesions.AIM To compare the conventional US and SWE features of PB-DLBCL and evaluate their diagnostic performance and prognostic value.METHODS We retrospectively reviewed the clinical data and US images of 32 patients with pathologically confirmed PB-DLBCL who underwent conventional US and SWE before treatment.We analyzed conventional US features(shape,margin,orientation,echo,posterior acoustic features,calcification,and vascularity)and SWE features(mean elasticity value,standard deviation,minimum elasticity value,maximum elasticity value,and lesion-to-fat ratio)of the PB-DLBCL lesions.Using receiver operating characteristic curve analysis,we determined the optimal cutoff values and diagnostic performance of conventional US and SWE features.We also performed a survival analysis to assess the prognostic value of conventional US and SWE features.RESULTS The results showed that the PB-DLBCL lesions were mostly irregular in shape(84.4%),microlobulated or spiculated in margins(75%),parallel in orientation(65.6%),hypoechoic in echo(87.5%),and had posterior acoustic enhancement(65.6%).Calcification was rare(6.3%)and vascularity was variable(31.3%avascular,37.5%hypovascular,and 31.3%hypervascular).The mean elasticity value of PB-DLBCL lesions was significantly higher than that of benign breast lesions(113.4±46.9 kPa vs 27.8±16.4 kPa,P<0.001).The optimal cutoff value of the mean elasticity for distinguishing PB-DLBCL from benign breast lesions was 54.5 kPa,with a sensitivity of 93.8%,specificity of 92.9%,positive predictive value of 93.8%,negative predictive value of 92.9%,and accuracy of 93.3%.The mean elasticity value was also significantly correlated with Ki-67 expression level(r=0.612,P<0.001),which is a marker of tumor proliferation and aggressiveness.Survival analysis showed that patients with higher mean elasticity values(>54.5 kPa)had worse overall survival(OS)and progression-free survival(PFS)than those with lower mean elasticity values(<54.5 kPa)(P=0.038 for OS and P=0.027 for PFS).CONCLUSION Conventional US and SWE provide useful information for diagnosing and forecasting PB-DLBCL.SWE excels in distinguishing PB-DLBCL from benign breast lesions,reflects tumor proliferation and aggressiveness,and improves disease management.
文摘Pprimary breast lymphoma （PBL） is rare, accounting for 0.04%-0.50% of breast malignancies and 1.7% of extranodal lymphoma The originally descnibect diagnostic criteria for PBL2 remains the standard definition for this disease. These criteria are breast location as the clinical site of presentation, absence of history of previous lymphoma or evidence of widespread disease at diagnosis, close association of lymphoma with breast tissue in pathologic specimens, and involvement of ipsilateral lymph nodes if they develop simultaneously with PBL.
文摘Primary non-Hodgkin’s lymphomas is an uncommon disease representing approximately 0.13% of all reported malignant mammary neoplasms. Clinically they are mainly observed as solitary lesions, but may also be seen as multiple foci. Herein, we present a very rare case with the diagnosis of multifocal malignant lymphoma of the breast. Case: A 56-year-old-female patient with a right palpable breast mass admitted to the hospital. Mammography and ultrasonography findings showed two different foci of hypoechoic solid mass forming lesion in the right breast. Excisional biopsy has been performed. In the histopathological evaluation, both lesions demonstrated foci of necrosis;mitotically active tumor cells with large nucleus and prominent nucleoli. The immunohistochemical analysis revealed diffuse LCA, CD20, CD43, focal CD68 positivity while pancytokeratin, EMA, CD34, SMA were negative. The case was diagnosed as Diffuse Large B-cell Lymphoma. We report a very rare case with a diagnosis of multifocal primary non-Hodgkin’s lymphoma of the breast.
文摘<strong>Background: </strong>Breast lymphomas are typical extranodal types of lymphoma, also known as Extranodal-lymphoma (ENL), which occur extremely infrequently, aggregating into a very small proportion of malignant breast tumors. The rarity of breast lymphomas is attributed to the scant lymphoid tissue content of the chest wall. <strong>Aims of Study: </strong>This case report is aimed at providing an up-to-date review of the literature on breast lymphomas for clinicians to, therefore, consider the possibility of this disease entity while treating a breast mass. <strong>Case Presentation:</strong> A case was reported of a 52-year man with chief mammary non-Hodgkin breast ENL when fine-needle aspiration cytology (FNAC) was not leading to a firm conclusion or result. Following an incisional biopsy, he was found to have a primary breast lymphoma. Later, the patient was diagnosed with the diffuse large B-cell type of lymphoma also known as non-Hodgkin’s Lymphoma (NHL). He had a complete reduction and disappearances of all the signs and symptoms of the disease after a course of neoadjuvant chemotherapy: Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone (CHOP). <strong>CONCLUSION: </strong>Based on the above case presentation, it is vital for health care professionals and oncologists to recognize the disease by assessing the breast mass accurately with more entities so that proper diagnosis via core biopsy (incisional biopsy) can eliminate the PBL before further treatment is required.
文摘目的探讨乳腺淋巴瘤(breast lymphoma,BL)的临床病理学特征、诊断及鉴别诊断。方法收集72例BL的临床病理资料,采用免疫组化EnVision两步法染色,应用FISH法检测C-myc、BCL-2、BCL-6基因扩增及断裂重排情况;应用BIOMED-2 PCR检测T/B细胞基因重排;运用原位杂交法检测EBER,分析其与临床病理特征的关系。结果72例BL中女性69例,男性3例;发病年龄24~83岁,中位年龄55岁。BL影像学特征具有非特异性,与乳腺癌的临床表现相似;72例BL中弥漫大B细胞淋巴瘤(diffused large B cell lymphoma,DLBCL)52例,结外黏膜相关淋巴组织边缘区淋巴瘤(extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue,MALT)7例,T淋巴母细胞性淋巴瘤(T lymphoblastic lymphoma,T-LBL)6例,其余少见类型为7例。52例DLBCL经原位杂交检测EBER均阴性,FISH检测2例有BCL-6基因断裂。16例患者具有完整临床病理资料,原发性乳腺淋巴瘤(primary breast lymphoma,PBL)12例,继发性乳腺淋巴瘤(secondary breast lymphoma,SBL)4例,两组患者预后均较差,差异无统计学意义(P>0.05)。结论BL的病理类型以DLBCL为主,男性患者罕见。BL通过影像学鉴别难度较大,主要通过穿刺活检病理诊断;PBL和SBL的临床病理特征及预后,差异无统计学意义。
