A case of primary breast diffuse large B cell lymphoma
Main Article Content
Abstract
Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin’s lymphoma with limited data. We here report a case of primary breast diffuse large B-cell lymphoma mimicking breast cancer. A 52-year-old woman had a painless mass in her right breast. Fine needle aspiration cytology and core biopsy were performed which suggested malignant features but could not confirm the specific subtype. Excisional biopsy then was conducted revealing non-Hodgkin lymphoma, which was subsequently confirmed with histopathology and diagnosed as diffuse large B-cell lymphoma (DLBCL). A chest computed tomography scan revealed a 3.5 cm sized breast mass with skin thickening and modest lymphadenopathy in the ipsilateral axilla. The patient received six courses of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab) chemotherapy, then whole breast radiation (30Gy in 15 fractions). At 12 months of follow-up, the patient survives with no evidence of disease. No morbidities occurred in this patient during the follow-up period. We briefly review the current practice pattern in patients with primary breast diffuse large B-cell lymphoma.
Article Details
Keywords
Primary breast lymphoma (PBL), DLBCL, R-CHOP
References
2. Lyons JA, Myles J, Pohlman B, Macklis RM, Crowe J, Crownover RL. Treatment and prognosis of primary breast lymphoma: a review of 13 cases. Am J Clin Oncol. 2000;23(4):334-6.
3. Mehta DP, Chirmade P, Anand AS, Parikh S. Primary diffuse large B-cell lymphoma of the breast: A rare case and review of literature. Indian J Med Paediatr Oncol Off J Indian Soc Med Paediatr Oncol. 2017;38(2):244.
4. Ferguson DJP. Intraepithelial lymphocytes and macrophages in the normal breast. Virchows Arch A. 1985;407(4):369-78.
5. Yhim H-Y, Kang HJ, Choi YH, Kim SJ, Kim WS, Chae YS. Clinical outcomes and prognostic factors in patients with breast
diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study. BMC Cancer. 2010;10(1):321.
6. Yang H, Lang RG, Liu FF, Wang XF, Jin ZJ, Lü AJ. Primary lymphoma of breast: a clinicopathologic and prognostic study of
40 cases. Zhonghua Bing Li Xue Za Zhi. 2011;40(2):79-84.
7. Anne N, Pallapothu R. Lymphoma of the breast: a mimic of inflammatory breast cancer. World J Surg Oncol. 2011;9(1):1-4.
8. Zack JR, Trevisan SG, Gupta M. Primary breast lymphoma originating in a benign intramammary lymph node. Am J Roentgenol. 2001;177(1):177-8.
9. Jennings WC, Baker RS, Murray SS, Howard CA, Parker DE, Peabody LF. Primary breast lymphoma: the role of mastectomy and the importance of lymph node status. Ann Surg. 2007;245(5):784.
10. Cheah CY, Campbell BA, Seymour JF. Primary breast lymphoma. Cancer Treat Rev. 2014;40(8):900-8.
11. Ryan G, Martinelli G, Kuper-Hommel M, Tsang R, Pruneri G, Yuen K. Primary diffuse large B-cell lymphoma of the breast:
prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. Ann Oncol. 2008;19(2):233-41.
12. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103(1):275-82.
13. Yoshida S, Nakamura N, Sasaki Y, Yoshida S, Yasuda M, Sagara H. Primary breast diffuse large B-cell lymphoma shows a nongerminal center B-cell phenotype. Mod Pathol. 2005;18(3):398-405.
14. Jeanneret-Sozzi W, Taghian A, Epelbaum R, Poortmans P, Zwahlen D, Amsler B. Primary breast lymphoma: patient profile,
outcome and prognostic factors. A multicentre Rare Cancer Network study. BMC Cancer. 2008;8(1):1-7.
15. Avilés A, Delgado S, Nambo MJ, Neri N, Murillo E, Cleto S. Primary breast lymphoma: results of a controlled clinical trial. Oncology. 2005;69(3):256-60.
16. Villa D, Connors JM, Shenkier TN, Gascoyne RD, Sehn LH, Savage KJ. Incidence and risk factors for central nervous system
relapse in patients with diffuse large B-cell lymphoma: the impact of the addition of Rituximab to CHOP chemotherapy. Ann Oncol. 2010;21(5):1046-52.
17. Guirguis HR, Cheung MC, Mahrous M, Piliotis E, Berinstein N, Imrie KR. Impact of central nervous system (CNS) prophylaxis on the incidence and risk factors for CNS relapse in patients with diffuse large B‐cell lymphoma treated in the rituximab era: a single centre experience and review of the literature. Br J Haematol. 2012;159(1):39-49.