Suzuki Y, Tokuda Y, Okumura A, Saito Y, Ohta M, Kubota M, Makuuchi H, Tajima T, Umemura S, Osamura R Y
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Jpn J Clin Oncol. 2000 Jan;30(1):33-6. doi: 10.1093/jjco/hyd008.
We report three cases of malignant lymphoma (ML) of the breast and discuss diagnosis and management. The first case is a 35-year-old woman who had a left breast tumor. Fine needle aspiration cytology (FNAC) showed ML. Mastectomy was performed without any adjuvant chemotherapy. Histology revealed diffuse large B-cell lymphoma of REAL classification. Seventy one months after surgery, lesions indicating relapse were detected in nodes of the right axilla, mediastinum and para-aorta. She underwent eight cycles of CHOP regimen, but 1 month after the chemotherapy a brain metastasis was detected. The patient then received a high-dose methotrexate regimen with whole-skull irradiation. The second case is a 47-year-old woman who had anterior neck swelling and bilateral breast tumors. Histology of the tumor revealed diffuse large B-cell lymphoma. The patient underwent eight cycles of CHOP regimen and high-dose chemotherapy (HDC) with peripheral blood stem cell transplantation (PBSCT). Forty eight months after the PBSCT, there is no evidence of disease. The third case is a 38-year-old woman who had a right breast tumor. FNAC of the breast tumor showed ML and a CT scan of the chest revealed lymphadenopathy at the crus of the diaphragm. Histology of the tumor revealed low-grade B-cell lymphoma of MALT type. The patient underwent six cycles of CHOP regimen and HDC supported by PBSCT. Eighteen months after the PBSCT, relapse lesions were detected in nodes of the neck, mediastinum and renal hilum. The patient received nine cycles of a THP-COP regimen.
我们报告三例乳腺恶性淋巴瘤(ML)病例,并讨论其诊断与治疗。第一例为一名35岁女性,她患有左乳腺肿瘤。细针穿刺细胞学检查(FNAC)显示为ML。患者接受了乳房切除术,未进行任何辅助化疗。组织学检查显示为REAL分类的弥漫性大B细胞淋巴瘤。术后71个月,在右腋窝、纵隔和腹主动脉旁淋巴结发现复发病变。她接受了8个周期的CHOP方案化疗,但化疗1个月后发现脑转移。患者随后接受了大剂量甲氨蝶呤方案联合全脑照射。第二例为一名47岁女性,她有颈部前方肿胀和双侧乳腺肿瘤。肿瘤组织学检查显示为弥漫性大B细胞淋巴瘤。患者接受了8个周期的CHOP方案化疗以及联合外周血干细胞移植(PBSCT)的大剂量化疗(HDC)。PBSCT术后48个月,无疾病证据。第三例为一名38岁女性,她有右乳腺肿瘤。乳腺肿瘤的FNAC显示为ML,胸部CT扫描显示膈肌脚处有淋巴结病。肿瘤组织学检查显示为MALT型低度B细胞淋巴瘤。患者接受了6个周期的CHOP方案化疗以及由PBSCT支持的HDC。PBSCT术后18个月,在颈部、纵隔和肾门淋巴结发现复发病变。患者接受了9个周期的THP-COP方案化疗。