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一例累及双侧乳房的伯基特淋巴瘤病例。

A Case of Burkitt's Lymphoma Involving Both Breasts.

作者信息

Ogawa Tomoko, Mizutani Minoru, Yabana Tadashi, Miyahara Shigeki, Murabayashi Koji

机构信息

First Department of Surgery, School of Medicine, Mie University 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.

出版信息

Breast Cancer. 2005;12(3):234-7. doi: 10.2325/jbcs.12.234.

Abstract

Primary malignant lymphoma of the breast is rare, and Burkitt's lymphoma is especially rare. We report the case of a 44-year-old woman in whom Burkitt's lymphoma involving both breasts was diagnosed. The patient was referred to our hospital because of a diffuse, firm swelling, like a bulky ball, in both breasts. Fine-needle aspiration cytology (FNAC) of both breast masses revealed malignant lymphoma(ML), and diffuse large B-cell lymphoma was diagnosed based on the results of immunohistochemical studies of a core needle biopsy specimen. The gallium scan revealed very hot lesions in both breasts, but there was no evidence of disseminated disease. We instituted initial therapy, with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus intrathecal chemotherapy without performing a chromosome analysis, because the clinical course was very aggressive. A CR was achieved, but after eight cycles of CHOP therapy, the ML relapsed. We then resected the mass in the left breast, and when examination of the surgical specimen revealed relapse of ML and t (8;11) (q24;q32) translocation, Burkitt's lymphoma was diagnosed. High-dose chemotherapy followed by peripheral-blood stem cell transplantation was performed, but the patient died 10 months after her initial presentation at our hospital.

摘要

原发性乳腺恶性淋巴瘤罕见,伯基特淋巴瘤尤其罕见。我们报告一例44岁女性,诊断为双侧乳腺伯基特淋巴瘤。该患者因双侧乳腺弥漫性、质地硬的肿块,类似大球状物,而转诊至我院。双侧乳腺肿块的细针穿刺细胞学检查(FNAC)显示为恶性淋巴瘤(ML),根据粗针活检标本的免疫组化研究结果诊断为弥漫性大B细胞淋巴瘤。镓扫描显示双侧乳腺有高代谢病灶,但无播散性疾病证据。由于临床病程进展迅速,我们未进行染色体分析,直接采用环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)方案联合鞘内化疗进行初始治疗。患者达到完全缓解(CR),但在CHOP治疗8个周期后,ML复发。随后我们切除了左侧乳腺肿块,手术标本检查显示ML复发且存在t(8;11)(q24;q32)易位,诊断为伯基特淋巴瘤。患者接受了大剂量化疗及外周血干细胞移植,但在我院初诊10个月后死亡。

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