Tamaoki Mikako, Nio Yoshinori, Tsuboi Kazuhiko, Nio Marika, Tamaoki Masashi, Maruyama Riruke
Nio Breast Surgery Clinic, Kyoto, Japan.
Department of Pathology, Faculty of Medicine, Shimane University, Izumo, Japan.
Oncol Lett. 2014 Apr;7(4):1001-1006. doi: 10.3892/ol.2014.1885. Epub 2014 Feb 14.
The double presentation of breast cancer and follicular lymphoma is extremely rare, and only six cases have previously been reported in the literature. In the present study, a case of synchronous ductal carcinoma (DCIS) of the breast and follicular lymphoma is reported. During an annual breast screening procedure, a 49-year-old female presented with a hard induration under the nipple of the right breast and swelling of a soft lymph node (LN) in the right axilla. Mammography and ultrasonography revealed two lesions in the right breast: One was a tumor with microcalcification, 1.0 cm in diameter, and the other was a large, crude calcification, 2.5 cm in diameter. In addition, computed tomography and positron emission tomography revealed swellings of the bilateral axillary (Ax) LN and intra-abdominal para-aortic LN. The patient underwent excisions of the large calcified mass, a micro-calcified tumor and the right AxLN. The pathological and immunohistochemical studies revealed fat necrosis and DCIS of the breast, which was positive for the estrogen receptor and the progesterone receptor, while human epidermal growth factor receptor II protein expression was evaluated as 2+ and stage was classified as pTis pN0 M0, stage 0. Furthermore, the Ax node was diagnosed as follicular lymphoma, which was positive for cluster of differentiation (CD)20, CD79a, CD10 and B-cell lymphoma (Bcl)-2 protein, but negative for Bcl-6 protein. The clinical stage was classified as stage III. The patient was administered chemotherapy followed by radiotherapy to the conserved breast. Two years have passed since the surgery, and the patient is disease-free.
乳腺癌与滤泡性淋巴瘤同时出现极为罕见，此前文献仅报道过6例。在本研究中，报告了1例乳腺导管原位癌（DCIS）与滤泡性淋巴瘤同时发生的病例。在年度乳腺筛查过程中，一名49岁女性右乳乳头下出现硬性硬结，右腋窝有一个柔软淋巴结（LN）肿大。乳腺钼靶和超声检查发现右乳有两个病灶：一个是直径1.0 cm的微钙化肿瘤，另一个是直径2.5 cm的粗大钙化灶。此外，计算机断层扫描和正电子发射断层扫描显示双侧腋窝（Ax）LN和腹主动脉旁LN肿大。患者接受了大钙化肿块、微钙化肿瘤及右AxLN的切除术。病理和免疫组化研究显示乳腺脂肪坏死和DCIS，雌激素受体和孕激素受体呈阳性，人表皮生长因子受体II蛋白表达评估为2+，分期为pTis pN0 M0，0期。此外，Ax淋巴结诊断为滤泡性淋巴瘤，分化簇（CD）20、CD79a、CD10和B细胞淋巴瘤（Bcl）-2蛋白呈阳性，但Bcl-6蛋白呈阴性。临床分期为III期。患者接受了化疗，随后对保留的乳房进行了放疗。手术已过去两年，患者无病生存。
