Gowda Varun, Shelar Deepika, Harbade Suresh, Jadhav Sarojini, Jadhav Rasika
Department of General Surgery, Government Medical College, Aurangabad, Maharashtra, India.
Department of General Surgery, Government Medical College, Aurangabad, Maharashtra, India.
Int J Surg Case Rep. 2023 Jun;107:108273. doi: 10.1016/j.ijscr.2023.108273. Epub 2023 Apr 28.
INTRODUCTION & IMPORTANCE: Primary breast lymphoma (PBL) is a rare extra nodal site of non-Hodgkin lymphoma and constitutes 0.4-0.5 % of all breast neoplasms. It mostly affects women. Breast lymphoma is divided into two types: primary and secondary. Primary Breast Lymphoma is when cancerous cells form in both the mammary tissue and the lymphatic system, without any other signs of cancer elsewhere in the body. PBL is usually a non-Hodgkin's B-cell type, with diffuse large B-cell lymphoma (DLBCL) being the most common type.
Here by described is a case report of 24 years primigravida in third trimester who presented with the complaint of a painful swelling in the left breast, mimicking breast abscess. At the time of presentation, patient denied Incision and Drainage due to consequent risks involved in premature delivery of the baby. Post-delivery patient underwent wound debridement on emergency basis. Biopsies revealed primary breast lymphoma (B-cell). She was referred for chemotherapy. Following which she succumbed after 2 cycles of chemotherapy.
Primary breast lymphoma is considered to be a disease with the potential of systemic diffusion. It typically presents as a painless breast mass in 85 % of cases, but may be mistaken for mastitis during pregnancy. Non-responsive mastitis in pregnant or lactating women should be investigated as it may be a symptom of breast lymphoma. Early detection is crucial due to the aggressive nature of the lesion and prognosis.
Rapidly progressive, Clinical, and Imaging difficulties for diagnosis, Delay in response to treatment makes us to consider Primary Breast Lymphoma in all patients with breast lump.
原发性乳腺淋巴瘤（PBL）是一种罕见的非霍奇金淋巴瘤结外部位，占所有乳腺肿瘤的0.4 - 0.5%。它主要影响女性。乳腺淋巴瘤分为原发性和继发性两种类型。原发性乳腺淋巴瘤是指癌细胞在乳腺组织和淋巴系统中形成，而身体其他部位无任何其他癌症迹象。PBL通常为非霍奇金B细胞型，弥漫性大B细胞淋巴瘤（DLBCL）是最常见的类型。
本文描述了一例24岁初产妇孕晚期的病例，患者主诉左乳疼痛性肿胀，类似乳腺脓肿。就诊时，患者因担心早产风险而拒绝切开引流。产后患者紧急接受了伤口清创。活检显示为原发性乳腺淋巴瘤（B细胞型）。她被转诊接受化疗。之后，她在接受2个周期化疗后死亡。
原发性乳腺淋巴瘤被认为是一种有全身扩散潜力的疾病。在85%的病例中，它通常表现为无痛性乳腺肿块，但在孕期可能被误诊为乳腺炎。怀孕或哺乳期妇女对治疗无反应的乳腺炎应进行检查，因为这可能是乳腺淋巴瘤的症状。由于病变的侵袭性和预后，早期检测至关重要。
快速进展、临床及影像学诊断困难、治疗反应延迟使我们在所有乳腺肿块患者中都应考虑原发性乳腺淋巴瘤。
