Bhele Sanica, Gujral Sumeet
Department of Pathology, Tata Memorial Hospital, Parel, Mumbai.
Indian J Pathol Microbiol. 2007 Oct;50(4):816-8.
Primary non-Hodgkin's lymphoma (NHL) of the breast is uncommon and the bilateral involvement is extremely rare. Usually, primary breast lymphoma is of B-cell phenotype, most common subtype being the diffuse large B-cell lymphoma. Preoperative differentiation of lymphoma from carcinoma is essential and limited material can pose diagnostic problem unless the index of suspicion is high. Twenty six year old pregnant lady, presented with bilateral breast lumps with a clinical impression of carcinoma. Fine needle aspiration cytology (FNAC) followed by biopsy of the breast mass was performed and a diagnosis of NHL, peripheral T-cell type (not otherwise specified) was made. She received 8 cycles of CHOP chemotherapy and showed dramatic improvement with regression of bilateral breast masses. She had an uneventful normal delivery and both the mother and the child are doing well. Since FNAC is a primary diagnostic tool for all breast lesions, a differential of lymphoma should always be kept in mind in all poorly differentiated malignant tumours. Such cases need biopsy confirmation and immunophenotyping for further sub-typing.
原发性乳腺非霍奇金淋巴瘤(NHL)并不常见,双侧受累极为罕见。通常,原发性乳腺淋巴瘤为B细胞表型,最常见的亚型是弥漫性大B细胞淋巴瘤。术前鉴别淋巴瘤和癌至关重要,除非怀疑指数很高,否则有限的材料可能会带来诊断难题。一名26岁的孕妇,双侧乳房出现肿块,临床诊断为癌。进行了细针穿刺细胞学检查(FNAC),随后对乳房肿块进行活检,诊断为外周T细胞型NHL(未另行说明)。她接受了8个周期的CHOP化疗,双侧乳房肿块消退,病情显著改善。她顺利顺产,母婴均状况良好。由于FNAC是所有乳腺病变的主要诊断工具,对于所有低分化恶性肿瘤,都应始终考虑淋巴瘤的鉴别诊断。此类病例需要活检确认并进行免疫表型分析以进一步分型。