Multifocal Malignant Lymphoma of the Breast

Elmas Ozgun, Deniz Tuncel, Ayca Tan, Aynur Albayrak, Sehnaz Sayhan, Nurten Bozlak

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Department of Pathology, I. Sevki Atasagun State Hospital, Nevsehir, Turkey.

DOI: 10.4236/ojpathology.2013.33023                

Abstract

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.

Keywords

Lymphoma; Breast; Multifocal

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	L. M. Sun, E. Y. Huang, F. Y. Meng, N. J. Chang, L. M. Chung, J. A. Liang, et al., “Primary Breast Lymphoma Clinically Mimicking Acute Mastitis: A Case Report,” Tumori, Vol. 97, No. 2, 2011, pp. 233-235.
[2]	A. Sanguinetti, M. Ragusa, R. Lucchini, M. Monacelli, F. Calzolari, C. Misso, et al., “Primary Breast Lymphoma: Case Reports and Review of the Literature,” Il Giornale di Chirurgia, Vol. 29, No. 5, 2008, pp. 230-232.
[3]	K. Vaishnav, S. Shah, S. Pandhi and Y. Rathi, “Multifocal Bilateral Breast Masses in HIV-Positive Status,” Indian Journal of Cancer, Vol. 48, No. 2, 2011, pp. 253-255.doi:10.4103/0019-509X.82878
[4]	D. Gupta, V. Shidham, V. Zemba-Palko and A. Keshgegian, “Primary Bilateral Mucosa Associated Lymphoid Tissue Lymphoma of the Breast with Atypical Ductal Hyperplasia and Localized Amyloidosis. A Case Report and Review of the Literature,” Archives of Pathology & Laboratory Medicine, Vol. 124, No. 8, 2000, pp. 1233-1236.
[5]	S. M. Domchek, J. L. Hecht, M. D. Fleming, G. S. Pinkus and G. P. Canellos, “Lymphomas of the Breast: Primary and Secondary Involvement,” Cancer, Vol. 94, No. 1, 2002, pp. 6-13. doi:10.1002/cncr.10163
[6]	R. Giardini, C. Piccolo and F. Rilke, “Primary Non-Hodgkin’s Lymphomas of the Female Breast,” Cancer, Vol. 69, No. 3, 1992, pp. 725-735.
[7]	J. M. Xu, Q. Zha, X. M. Zuo and J. M. Tian, “Primary Non-Hodgkin’s Lymphoma of the Breast: Mammography, Ultrasound, MRI and Pathologic Findings,” Future Oncology, Vol. 8, No. 1, 2012, pp. 105-109. doi:10.2217/fon.11.132
[8]	G. F. Ryan, D. R. Roos and J. F. Seymour, “Primary Non-Hodgkin’s Lymphoma of the Breast: Retrospective Analysis of Prognosis and Patterns of Failure in Two Australian Centers,” Clinical Lymphoma Myeloma and Leukemia, Vol. 6, No. 4, 2006, pp. 337-341. doi:10.3816/CLM.2006.n.010
[9]	C. Wiseman and K. T. Liao, “Primary Lymphoma of the Breast,” Cancer, Vol. 29, No. 6, 1972, pp. 1705-1712.
[10]	R. Baker, G. Slayden and W. Jennings, “Multifocal Pri-Mary Breast Lymphoma,” Southern Medical Journal, Vol. 98, No. 10, 2005, pp. 1045-1048. doi:10.1097/01.smj.0000182173.05977.2e
[11]	W. C. Jennings, R. S. Baker, S. S. Murray, C. A. Howard, D. E. Parker, L. F. Peabody, et al., “Primary Breast Lymphoma: The Role of Mastectomy and the Importance of Lymph Node Status,” Annals of Surgery, Vol. 245, No. 5, 2007, pp. 784-789. doi:10.1097/01.sla.0000254418.90192.59
[12]	M. T. Liu, C. Y. Hsieh, A. Y. Wang, C. P. Pi, T. H. Chang, C. C. Huang, et al., “Primary Breast Lymphoma: A Pooled Analysis of Prognostic Factors and Survival in 93 Cases,” Annals of Saudi Medicine, Vol. 25, No. 4, 2005, pp. 288-293.
[13]	B. Mouna, B. Saber, El H. Tijani, M. Hind, T. Amina and E. Hassan, “Primary Malignant Non-Hodgkin’s Lymphoma of the Breast: A Study of Seven Cases and Literature Review,” World Journal of Surgical Oncology, Vol. 10, 2012, p. 151. doi:10.1186/1477-7819-10-151
[14]	G. Mpallas, G. Simatos, A. Tasidou, E. Patra, G. Galateros, G. Lakiotis, et al., “Primary Breast Lymphoma in a Male Patient,” Breast, Vol. 13, No. 5, 2004, pp. 436-438. doi:10.1016/j.breast.2003.11.002
[15]	A. Neri, S. Caruso, G. Cerullo, M. P. Lenoci, D. Marrelli and F. Roviello, “Primary Non-Hodgkin’s Breast Lymphoma: Surgical Approach,” Cases Journal, Vol. 1, No. 1, 2008, p. 311. doi:10.1186/1757-1626-1-311