PRIMARY BREAST LYMPHOMA: AN IMMUNOMORPHOLOGIC STUDY OF A RARE ENTITY

Deepika V, Premalata C S, Suma M N

Abstract


Introduction& Objective: Breast lymphomas can be either arising primarily from the breast or as secondary involvement of the
breast by primary nodal lymphomas. Primary breast lymphomas are extremely rare and account for 0.04 to 0.5% of all the breast
malignancies and 1 to 2% of the extra nodal lymphomas. We studied the clinicopathologic features and subtypes of this rare
disease at a regional cancer centre in South India.
Methods: All cases of primary breast lymphomas diagnosed over a period of 11.5yrs, were included in the study. The
demographic, morphologic and immunophenotypic features were analysed.
Results: Thirteen cases of primary breast lymphomas were diagnosed and all were females. The mean age at presentation was
42.5yrs, with an age range of 19 to 65yrs. All the patients presented with unilateral breast lesion except one case with bilateral
involvement. All 13 cases were Non-Hodgkin lymphomas(NHL), of which eleven cases were B-cell type and two cases were T-cell
type (both anaplastic Large cell lymphomas- ALCL) and two cases were immunocompromised. The most common subtype of Bcell
lymphoma was Diffuse Large B Cell Lymphoma (DLBCL).
Discussion & Conclusion: DLBCL was the commonest primary breast lymphoma, most of them of the non germinal
centre(NGCB) subtype. The two cases of ALCLs in our study were non- implant associated and Anaplastic Lymphoma Kinase(ALK-
1) positive. There was one case of plasmablastic lymphoma in a HIV infected individual. High index of suspicion and
immunophenotyping play a vital role in the diagnosis of primary breast lymphomas and helps to make appropriate treatment
decisions which in turn has prognostic implications.


Keywords


Primary Breast Lymphoma, DLBCL, ALCL.

Full Text:

PDF

References


Wiseman C, Liao K. Primary lymphoma of the breast. Cancer.1972, 29:1705-1712.

Hugh J, Jackson F, Hanson J, Poppema S. Primary breast lymphoma: an immunohistologic study of 20 new cases. Cancer. 1990, 66:2602-2611.

Ferry JA. Diagnosis of lymphoma in extranodal sites other than skin. In: Jaffe ES, Harris NL, Vardiman JW et al. Hematopathology. First edition. Philadelphia. Saunders/Elsevier. 2011.

Amine OE, Zahra K, Gabsi A, Goucha A, Hassouna JB, Rahal K and Gamoudi A. Primary Breast Lymphoma: A Study of 9 Cases. Journal of Cancer and Tumor International. 2016, 4(3): 1-6.

Sashiyama H, Abe Y, Miyazawa Y, Nagashima T, Hasegawa M, Okuyama K, Kuwahara T, Takagi T. Primary non-Hodgkin’s lymphoma of the male breast: a case report. Breast Cancer. 1999, 6: 55–58.

Harris NL, Jaffe ES. Lymphoid and haematopoietic tumours. In: Lakhani SR, Ellis IO, Schnitt SJ et al. WHO classification of tumours of the breast. Fourth edition. Lyon. IARC. 2012.

Patel P, Hanson DL, Sullivan PS, Novak RM, Moorman AC, Tong TC, Holmberg SD, Brooks JT, Adult and Adolescent Spectrum of Disease Project and HIV Outpatient Study Investigators: Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992–2003. Ann Intern Med. 2008, 148:728-36.

Chadburn A, Abdul-Nabi A, Teruya B, Lo A. Lymphoid Proliferations Associated With Human Immunodeficiency Virus Infection. Arch Pathol Lab Med. 2013;137(3):360-370.

Pérez FF, Lavernia J, Aguiar-Bujanda D et al. Primary Breast Lymphoma: Analysis of 55 Cases of the Spanish Lymphoma Oncology Group. Clinical Lymphoma, Myeloma & Leukemia. 2016; 17(3), 186-91.

Ferry JA. Lymphomas of the thorax. In: Ferry JA. Extranodal Lymphomas. Philadelphia. Saunders/Elsevier. 2011.

Hansra D, Montague N, Stefanovic A, et al. Oral and Extraoral Plasmablastic Lymphoma Similarities and Differences in Clinicopathologic Characteristics. Am J Clin Pathol. 2010;134:710-719.

Delsol G, Falini B, MOtier-Hermelink HK et al. Anaplastic large cell lymphoma (ALCL), ALK- Positive. In: Swerdlow S, Campo E, Harris N et al, editors. WHO classification tumours of haematopoietic and lymphoid tissues. Fourth edition. Lyon. IARC. 2008.

Vega F, Chang CC, Medeiros LJ, et al. Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles. Mod Pathol. 2005; 18(6):806–815.

de Jong D, Vasmel WL, de Boer JP, et al. Anaplastic large cell lymphoma in women with breast implants. JAMA. 2008; 300: 2030–2035.

Daneshbod Y, Oryan A, Khojasteh HN, Rasekhi A, Ahmadi N. Primary ALK-positive anaplastic large cell lymphoma of the breast: a case report and review of the literature. J Pediatr Hematol Oncol. 2010 Mar; 32(2): e75-8.

Aguilera NS, Tavassoli FA, Chu WS, et al. T-cell lymphoma presenting in the breast: a histologic, immunophenotypic and molecular genetic study of four cases. Mod Pathol. 2000;13: 599–605.

Miranda RN, Lin L, Talwalkar SS, et al. Anaplastic large cell lymphoma involving the breast: a clinicopathologic study of 6 cases and review of the literature. Arch Pathol Lab Med. 2009; 133:1383–1390.

Caon J, Wai ES, Hart J et al. Treatment and outcomes of primary breast lymphoma. Clinical Breast Cancer. 2012; 12(6): 412-9.

Jennings WC, Baker RS, Murray SS et al. Primary breast lymphoma: the role of mastectomy and the importance of lymph node status. Ann Surg. 2007; 245: 784–789.


Refbacks

  • There are currently no refbacks.