Lokesh Kn, Sathyanarayanan Vishwanath, Lakshmaiah Kc, Suresh Tm, Lokanatha D, Govinda Babu K, Jacob Linu Abraham, Babu Suresh
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka 560029, India.
Ecancermedicalscience. 2013 Sep 5;7:347. doi: 10.3332/ecancer.2013.347. eCollection 2013.
Primary breast lymphoma (PBL) in males is a rare clinical entity and has been reported in anecdotal case reports up until now. We report two cases of PBL from a tertiary care centre in Southern India. A 46-year-old male presented with a lump in the right breast with right axillary lymphadenopathy; a biopsy with immunohistochemistry showed neoplastic cells positive for CD 20 and negative for CD 30, epithelial membrane antigen, anaplastic lymphoma kinase, suggestive of diffuse large B cell lymphoma stage IIEA. He received three cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy, then developed a cerebrovascular accident, and died. The other patient was a 60-year-old male with a left breast lump with left axillary lymphadenopathy. The biopsy with immunohistochemistry showed neoplastic cells positive for CD 23 and CD 5, suggestive of small lymphocytic lymphoma stage IIEA. Initially he received three cycles of cyclophosphamide, vincristine, and prednisolone (COP) and defaulted. One year later, he received six cycles of COP chemotherapy, developed progressive disease, and was lost to follow-up. The literature on PBL in males was reviewed. To conclude, PBL in males is an extremely rare disease and can mimic breast cancer. A strong index of suspicion with early diagnosis by biopsy with immunohistochemistry and treatment with rituximab- and anthracycline-based chemotherapy followed by radiotherapy will improve overall survival.
男性原发性乳腺淋巴瘤（PBL）是一种罕见的临床实体，迄今为止仅有零星的病例报告。我们报告了印度南部一家三级医疗中心的两例PBL病例。一名46岁男性因右乳肿块伴右腋窝淋巴结肿大就诊；免疫组化活检显示肿瘤细胞CD 20阳性，CD 30、上皮膜抗原、间变性淋巴瘤激酶阴性，提示为IIEA期弥漫性大B细胞淋巴瘤。他接受了三个周期的CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松龙）化疗，随后发生脑血管意外并死亡。另一名患者是一名60岁男性，左乳肿块伴左腋窝淋巴结肿大。免疫组化活检显示肿瘤细胞CD 23和CD 5阳性，提示为IIEA期小淋巴细胞淋巴瘤。最初他接受了三个周期的环磷酰胺、长春新碱和泼尼松龙（COP）化疗，但未坚持。一年后，他接受了六个周期的COP化疗，病情进展，失访。我们对男性PBL的文献进行了综述。总之，男性PBL是一种极其罕见的疾病，可酷似乳腺癌。高度怀疑并通过免疫组化活检早期诊断，采用利妥昔单抗和蒽环类药物为基础的化疗并联合放疗进行治疗，将提高总体生存率。
