Primary breast lymphoma

a case report

Abstract

The primary breast lymphoma (PBL) is a rare tumor, accounting for up to 0.5% of breast cancers. We report the case of a 56 year-old female patient, presenting with a lump in the union of the lateral quadrants of the right breast, measuring 4.0 x 3.0 cm, which appeared about 2 years ago and showed a progressive increase not related to any other symptoms. The right axilla had clinical and ultrasonographic signs of lymph node involvement. The mammography identified three lobulated defined nodules in the right breast, confirmed by ultrasound. The initial diagnosis, made by fine needle aspiration (FNA) and core biopsy, was an invasive ductal carcinoma of the breast. The immunohistochemical examination for the definition of hormone receptors accompanied by slide review revealed a diffuse large B cell lymphoma, CD20 positive. The patient underwent chemotherapy with rituximab, cyclophosphamid and prednisone (R-CHOP) with complete clinical response, and subsequently, radiotherapy of the breast. The most common type of PBL is the non-Hodgkin diffuse large cell lymphoma, which corresponds to approximately 2% of all extranodal lymphomas. The treatment of PBL consists of chemotherapy and radiotherapy, and surgical treatment being reserved for selected cases.