La Pinta M, Stagnitto D, Lengua G, Aicardi P, Loreti A, Bellioni M, Ponzani T, Ascarelli A, Dell'osso A
SSD Centro di Patologia della mammella e Chirurgia Ricostruttiva, Azienda Ospedaliera San Giovanni Addolorata, Via Padre Giovanni Antonio Filippini 144, 00144 Rome, Italy.
Minerva Chir. 2007 Feb;62(1):33-7.
Primary non-Hodgkin's lymphoma of the breast is a rare entity representing 0.04-0.5% of all malignant female breast tumors, less than 1% of all patients with non-Hodgkin lymphoma and approximately 1.7-2.2% of all patients with extranodal non-Hodgkin lymphomas. A 75 years old patient presented with masses in the lateral part of the left breast for 6 weeks. Ultrasound detected 3 masses suggesting fibroadenomas while mammography set the suspicion of breast multicentric carcinoma. Fine needle aspiration cytology of one mass showed low grade lymphoma subsequently confirmed with histopathology which diagnosed extranodal non-Hodgkin lymphoma MALT type CD 20+/CD 79a+/CD 3-/Bcl 2- and index of proliferation Ki 67=30% (stage IE). Primary non-Hodgkin lymphomas of the breast, though rare, should be considered in the differential diagnosis of breast malignancies. At present, a standard treatment doesn't exist yet; low grade lymphomas should be managed with excision biopsy and/or local radiation therapy, while high grade lymphomas should be managed with chemotherapy in association with radiation therapy.
原发性乳腺非霍奇金淋巴瘤是一种罕见的疾病,占所有女性乳腺恶性肿瘤的0.04 - 0.5%,占所有非霍奇金淋巴瘤患者的比例不到1%,占所有结外非霍奇金淋巴瘤患者的约1.7 - 2.2%。一名75岁患者左侧乳房外侧出现肿块6周。超声检查发现3个肿块,提示为纤维腺瘤,而乳腺钼靶检查怀疑为乳腺多中心癌。对其中一个肿块进行细针穿刺细胞学检查显示为低级别淋巴瘤,随后经组织病理学证实,诊断为结外非霍奇金淋巴瘤MALT型,CD 20+/CD 79a+/CD 3 - /Bcl 2 - ,增殖指数Ki 67 = 30%(IE期)。原发性乳腺非霍奇金淋巴瘤虽然罕见,但在乳腺恶性肿瘤的鉴别诊断中应予以考虑。目前尚无标准治疗方案;低级别淋巴瘤应采用切除活检和/或局部放射治疗,而高级别淋巴瘤应采用化疗联合放射治疗。