Wei Jianguo, Lin Caixia, Xu Chunwei, Xi Qun, Wang Cheng
Department of Pathology, The General Military Hospital of Beijing PLA, Beijing 100700, People's Republic of China.
Indian J Pathol Microbiol. 2015 Oct-Dec;58(4):546-9. doi: 10.4103/0377-4929.168863.
Burkitt lymphoma (BL) is a highly aggressive neoplasm, which arising from the germinal center or post germinal center B-cell. Primary breast lymphomas are extremely rare, and the most common histologic type is diffuse large B-cell lymphoma. Primary BL of the breast is much less common than the other types of lymphoma. Here, we report an extremely rare case of a 37-year-old Chinese female with localized bilateral breast, who was referred to our institution for bilateral breast swelling. The left breast tissue ultrasonography showed the short axis measuring 20.3 mm × 18.8 mm and the long axis measuring 22.1 mm × 20.8 mm soft tissue mass. The right breast tissue ultrasonography showed the short axis measuring 30.2 mm × 26.9 mm and the long axis measuring 33.5 mm × 2.18 mm. Coarse needle biopsy of breast masses demonstrated a non-Hodgkin's B-cell lymphoma. The patient underwent a bilateral mastectomy. Histological examination of the tumor showed a characteristic "starry sky" pattern, the medium-sized tumor cells were a monotonous pattern of growth, and there were many abnormal mitotic figures. The neoplastic cells strongly expressed CD20, CD79-μ, MUM-1, PAX-5, CD43 and Bcl-6, Ki-67 were nearly 100% positive, but negative for CD10, Bcl-2 and TdT. By fluorescence in situ hybridization an IGH-MYC gene fusion was detected in the tumor tissue which indicating the presence of a typical BL translocation t(8;14)(q24;q32). The final histopathological diagnosis was primary BL of the breast.
伯基特淋巴瘤（BL）是一种高度侵袭性肿瘤，起源于生发中心或生发中心后B细胞。原发性乳腺淋巴瘤极为罕见，最常见的组织学类型是弥漫性大B细胞淋巴瘤。乳腺原发性BL比其他类型的淋巴瘤更为少见。在此，我们报告一例极其罕见的37岁中国女性病例，其双侧乳腺局部出现肿胀，遂转诊至我院。左侧乳腺组织超声检查显示短轴为20.3mm×18.8mm，长轴为22.1mm×20.8mm的软组织肿块。右侧乳腺组织超声检查显示短轴为30.2mm×26.9mm，长轴为33.5mm×2.18mm。乳腺肿块粗针活检显示为非霍奇金B细胞淋巴瘤。该患者接受了双侧乳房切除术。肿瘤组织学检查显示出特征性的“星空”样图案，中等大小的肿瘤细胞呈单调生长模式，且有许多异常有丝分裂象。肿瘤细胞强烈表达CD20、CD79-μ、MUM-1、PAX-5、CD43和Bcl-6，Ki-67几乎100%呈阳性，但CD10、Bcl-2和TdT呈阴性。通过荧光原位杂交在肿瘤组织中检测到IGH-MYC基因融合，这表明存在典型的BL易位t(8;14)(q24;q32)。最终组织病理学诊断为乳腺原发性BL。
