Department of Radiology.
Department of Pathology.
Medicine (Baltimore). 2021 May 14;100(19):e25699. doi: 10.1097/MD.0000000000025699.
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an uncommon and aggressive hematologic malignancy that arises from plasmacytoid dendritic cells. BPDCN typically presents with skin lesions with or without involvement of lymph nodes, peripheral blood, or bone marrow. However, breast involvement of BPDCN is rare and there has been no report describing the radiologic features of BPDCN within breast parenchyma.
We report a case of a 47-year-old woman who presented with an incidentally detected hypermetabolic breast lesion on PET/CT with concurrent right cheek plaque.
Skin biopsy was performed for the right cheek plaque. Mammography and breast ultrasonography were performed to evaluate the breast lesion. The lesion was depicted as a 2.5 cm sized focal asymmetry on mammogram and an irregular heterogeneous echoic mass within the mammary zone of the right upper outer breast. Core needle biopsy was performed for the breast lesion. Histologic diagnosis of the two lesions was BPDCN.
The patient was treated with induction and consolidation chemotherapy and received allogenic peripheral blood stem cell transplantation.
The patient remains in complete remission state without relapse at 34 months since initial diagnosis.
This is the first case of BPDCN manifested as a breast parenchymal mass and assessed by diagnostic breast imaging tools (mammography and ultrasonography). This case report is significant for BPDCN within the breast parenchyma and presenting rare radiologic description of BPDCN.
原始细胞性浆细胞样树突细胞肿瘤（BPDCN）是一种罕见且侵袭性的血液系统恶性肿瘤，起源于浆细胞样树突细胞。BPDCN 通常表现为皮肤病变，伴有或不伴有淋巴结、外周血或骨髓受累。然而，BPDCN 累及乳腺较为罕见，目前尚无描述乳腺实质内 BPDCN 放射学特征的报道。
我们报告了 1 例 47 岁女性，其在 PET/CT 上偶然发现了一个代谢活跃的乳腺病变，同时伴有右面颊斑块。
对右面颊斑块进行了皮肤活检。为了评估乳腺病变，进行了乳腺 X 线摄影和超声检查。乳腺 X 线摄影显示病变为 2.5cm 大小的局灶性不对称，乳腺外上象限内不规则的不均匀回声肿块。对乳腺病变进行了空心针活检。两个病变的组织学诊断均为 BPDCN。
患者接受了诱导和巩固化疗，并进行了异基因外周血干细胞移植。
患者在初始诊断后 34 个月仍处于完全缓解状态，无复发。
这是首例表现为乳腺实质肿块并通过诊断性乳腺影像学工具（乳腺 X 线摄影和超声检查）评估的 BPDCN 病例。该病例报告对于乳腺实质内的 BPDCN 具有重要意义，并对 BPDCN 的罕见放射学表现进行了描述。
