Kenil M C, Monnier A, Zurlinden B, Rognon M, Cour A, Bertin M
Rev Fr Gynecol Obstet. 1987 Feb;82(2):119-25.
The malignant non-hodgkinian lymphoma (M.N.H.L.) with pripary mammary localization is relatively rare, but deserves to be accounted for in the evaluation of breast cancers. The diagnosis of the primary localization in the breast responds to definite criteria, well established by Wiseman and Liao. On the other hand, the initial mammary localization is more frequent, revealing a hemato-sarcoma clinically silent until then, but with nodal spread (most of the time lumbo-aortic). The problem is to know whether it is possible, in front of a breast nodule, to evoke lymphoma in view of some clinical and paraclinical characteristics. An accurate pathological diagnosis (International Formula for clinical use of the National Cancer Institute-1982) and a minutious work-up for spread determination (AnnArbor Classification) represent the two essential aspects of the prognosis. It is advised to resort to surgical excision-biopsy in order to obtain an exact histology with analysis of immunological markers, rather than an extemporaneous examination which often leads to the wrong diagnosis of cancer and a mutilating and unnecessary surgery. Progresses in chemotherapy have greatly contributed to improve survival of these hematosarcomas with extranodal localization, which remain however a neoplastic disease with a disseminating tendency.
原发性乳腺定位的恶性非霍奇金淋巴瘤（M.N.H.L.）相对罕见，但在乳腺癌评估中值得考虑。乳腺原发性定位的诊断符合Wiseman和Liao明确确立的特定标准。另一方面，最初的乳腺定位更为常见，揭示出一种此前临床上无症状的血液肉瘤，但伴有淋巴结扩散（大多数情况下为腰主动脉旁淋巴结）。问题在于，鉴于某些临床和辅助检查特征，面对乳腺结节时是否有可能怀疑淋巴瘤。准确的病理诊断（美国国立癌症研究所临床使用的国际公式 - 1982年）以及用于确定扩散情况的细致检查（AnnArbor分类）是预后的两个关键方面。建议采用手术切除活检以获得精确的组织学结果并分析免疫标志物，而不是进行术中检查，因为术中检查常常导致对癌症的错误诊断以及不必要的致残性手术。化疗的进展极大地有助于提高这些结外定位血液肉瘤的生存率，然而它们仍然是一种具有扩散倾向的肿瘤性疾病。
