Rare lymphoid malignancies of the breast: a report of two cases illustrating potential diagnostic pitfalls
Open Access
- 20 August 2009
- journal article
- case report
- Published by Springer Science and Business Media LLC in Journal of Hematopathology
- Vol. 2 (4), 237-244
- https://doi.org/10.1007/s12308-009-0043-y
Abstract
Breast involvement by lymphoma is uncommon and poses challenges in diagnosis. Lymphomas may clinically, radiologically, and morphologically mimic both benign and neoplastic conditions. We describe two cases of lymphoid malignancies predominantly involving the breast, both presenting diagnostic dilemmas. The first case, ALK-negative anaplastic large-cell lymphoma involving a seroma associated with a breast implant, is an emerging clinicopathologic entity. Anaplastic large-cell lymphoma has been identified in association with breast implants and seroma formation relatively recently. The second case, hairy cell leukemia involving the breast and ipsilateral axillary sentinel lymph node, is, to our knowledge, the first reported case of hairy cell leukemia involving the breast at the time of diagnosis. While a localized bone lesion was present at time of diagnosis, bone marrow involvement was relatively mild in comparison to that seen in the breast and lymph node. In the first case, lymphoma occurred in a clinical setting where malignancy was unsuspected, highlighting the importance of careful morphologic evaluation of paucicellular samples, as well as awareness of rare clinicopathologic entities, in avoiding a misdiagnosis of a benign inflammatory infiltrate. In the second case, the lymphoid neoplasm exhibited classic morphologic and immunophenotypic features, but presented at an unusual site of involvement. Knowledge of the patient's concurrent diagnosis of hairy cell leukemia involving the bone marrow and bone helped avoid a misdiagnosis of carcinoma rather than lymphoma.Keywords
This publication has 32 references indexed in Scilit:
- ALK− anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma ProjectBlood, 2008
- Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorderLaboratory Investigation, 2008
- Anaplastic Large Cell Lymphoma Arising in a Saline Breast Implant Capsule After Tissue Expander Breast ReconstructionAnnals of Plastic Surgery, 2007
- Clinical Presentations and Complications of Hairy Cell LeukemiaHematology/Oncology Clinics of North America, 2006
- Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936Leukemia, 2003
- Primary Breast LymphomaLeukemia & Lymphoma, 2003
- Breast Lymphoma Associated With Breast Implants: Two Case-reports and a Review of the LiteratureLeukemia & Lymphoma, 2002
- ALK expression in extranodal anaplastic large cell lymphoma favours systemic disease with (primary) nodal involvement and a good prognosis and occurs before disseminationJournal of Clinical Pathology, 2000
- Breast Prosthesis ReactionThe American Journal of Surgical Pathology, 1996
- Silicone Breakdown and Capsular Synovial Metaplasia in Textured-Wall Saline Breast ProsthesesPlastic and Reconstructive Surgery, 1994