Jabbour Gaby, El-Mabrok Gamela, Al-Thani Hassan, El-Menyar Ayman, Al Hijji Ibrahim, Napaki Sarbar
Department of Surgery, General Surgery, Hamad General Hospital, Doha, Qatar.
Department of Surgery, Clinical Research, Hamad General Hospital, Doha, Qatar.
Am J Case Rep. 2016 Feb 19;17:97-103. doi: 10.12659/ajcr.896264.
Primary breast lymphoma (PBL) is an unusual clinical entity accounting for 0.4-0.5% of all breast neoplasms. The usual presentation includes a painless palpable mass similar to that of breast carcinoma. Diffuse large B-cell lymphoma (DLBCL) is the most common identifiable type of PBL based on the histopathological examination.
We report an unusual case of a 43-year-old Indonesian woman who presented with a 7-month history of a painless mass in the left breast. A core needle biopsy revealed diffuse infiltration of large atypical lymphoid cells. The immuno-histochemical biomarkers confirmed the diagnosis of a DLBCL. A bone scan showed no evidence of bone metastasis. It was treated non-surgically, based on the decision of the breast multidisciplinary team (MDT). The patient was treated with 4 cycles of combination chemotherapy with R-CODOX/IVAC. A follow-up PET scan revealed non-significant mild F-18 fluorodeoxyglucose (FDG) uptake at the periphery of the residual left breast mass, indicating a radiologically favorable response.
Early and accurate diagnosis of PBL is crucial for selecting the appropriate MDT treatment strategies to avert potentially harmful surgical interventions.
原发性乳腺淋巴瘤(PBL)是一种罕见的临床实体,占所有乳腺肿瘤的0.4 - 0.5%。其常见表现包括一个与乳腺癌相似的可触及的无痛肿块。根据组织病理学检查,弥漫性大B细胞淋巴瘤(DLBCL)是PBL最常见的可识别类型。
我们报告一例不寻常的病例,一名43岁的印度尼西亚女性,有左侧乳房无痛肿块7个月的病史。粗针活检显示大量非典型淋巴细胞弥漫浸润。免疫组织化学生物标志物确诊为DLBCL。骨扫描未显示骨转移迹象。根据乳腺多学科团队(MDT)的决定,对其进行了非手术治疗。患者接受了4个周期的R - CODOX/IVAC联合化疗。随访PET扫描显示左乳残余肿块周边F - 18氟脱氧葡萄糖(FDG)摄取轻度增加但无显著意义,提示放射学反应良好。
PBL的早期准确诊断对于选择合适的MDT治疗策略以避免潜在有害的手术干预至关重要。