Anaplastic large cell lymphoma of breast masquerading suppurative mastitis on cytology
Linfoma anaplásico de células grandes de mama enmascarando mastitis supurativa en citología
Sailuja Maharjan, Bandana Satyal, Reena Baidya, Prakash Neupane
Abstract
Breast is an uncommon site of extra nodal lymphoma accounting for 2.2% of all extra nodal lymphomas. B cell lymphomas are more common than T cell types. The most common subtype is Diffuse Large B Cell Lymphoma. Breast lymphoma is very challenging to diagnose as it has nonspecific clinical and radiological features. We report a rare case of primary T cell lymphoma in a 20-year-old female. It was misdiagnosed as abscess on ultrasound and as suppurative mastitis on fine needle aspiration cytology (FNAC). However, excisional biopsy was suggestive of lymphoma and immunohistochemistry confirmed it as ALK positive, anaplastic large cell lymphoma. Even though FNAC is a part of the diagnostic triad for breast lesions, potential pitfalls cannot be overlooked and must be correlated with biopsy.
Keywords
Resumen
La mama es un sitio poco frecuente de linfoma extraganglionar que representa el 2,2 % de todos los linfomas extraganglionares. Los linfomas de células B son más comunes que los tipos de células T. El subtipo más común es el linfoma difuso de células B grandes. El linfoma de mama es muy difícil de diagnosticar, ya que tiene características clínicas y radiológicas inespecíficas. Presentamos un caso raro de linfoma primario de células T en una mujer de 20 años. Fue mal diagnosticado como absceso en ultrasonido y como mastitis supurativa en citología por aspiración con aguja fina (FNAC). Sin embargo, la biopsia por escisión sugirió linfoma y la inmunohistoquímica lo confirmó como linfoma anaplásico de células grandes ALK positivo. Aunque la FNAC es parte de la tríada diagnóstica de las lesiones mamarias, no se pueden pasar por alto los peligros potenciales y se deben correlacionar con la biopsia.
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References
1. Marinopoulos S, Safioleas P, Skorda L, Vassilopoulou E, Zagouri F, Sotiropoulou M, et al. Breast lymphoma in a patient with B-cell Non Hodgkin Lymphoma: A case report study. Int J Surg Case Rep. 2017;40:1-5. doi: 10.1016/j.ijscr.2017.09.003.
2. Yang H, Lang R, Fu L. Primary breast lymphoma (PBL): A literature review. Clin Oncol Cancer Res. 2011;8(3):128-32. doi: 10.1007/s11805-011-0570-z.
3. Al Battah AH, Al Kuwari EA, Hascsi Z, Nashwan AJ, Elomari H, Elsabah H, et al. Diffuse Large B-Cell Breast Lymphoma: A Case Series. Clin Med Insights Blood Disord. 2017;10:1179545X17725034. doi: 10.1177/1179545X17725034.
4. Raj SD, Shurafa M, Shah Z, Raj KM, Fishman MDC, Dialani VM. Primary and Secondary Breast Lymphoma: Clinical, Pathologic, and Multimodality Imaging Review. Radiographics. 2019;39(3):610-25. doi: 10.1148/rg.2019180097.
5. Nisar U, Khan M, Nisar S, Khan S. Primary Breast Lymphoma with Unconventional Presentation: A Case Report. J Leuk. 2017;05(03):3-6. doi: 10.4172/2329-6917.1000238.
6. Chaudhuri A, Samaddar A, Nag D. Primary Breast Lymphoma : a rare case report with emphasis on role of cytology , cell block and tru-cut biopsy in diagnosis. Ann Appl Bio-Sci. 2015;2(3)25-8.
7. Radkani P, Joshi D, Paramo JC, Mesko TW. Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg. 2014;149(1):91-3. doi: 10.1001/jamasurg.2013.2283.
8. Thodou E, Befani M, Triantafyllidis G, Choreftaki T, Kanellis G, Giannakoulas N. Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment. Case Rep Hematol. 2019;2019:9256807. doi: 10.1155/2019/9256807.
9. Broco S, Bonito N, Jacinto P, Sousa G, Gervásio H. Primary non-Hodgkin lymphoma and invasive ductal carcinoma in the same breast: a rare case
report. Clin Transl Oncol. 2009;11(3):186-8. doi: 10.1007/s12094-009-0337-7.
10. Pandure M, Karle R, Dongre S, Baviskar B. Primary non-Hodgkin’ s lymphoma of the breast : a case report Internet Journal of Medical Update. 2013;8(1):34-6.
11. Jain MF, Khandekar SL, Mahadani JW, Raut WK. Report of a case of primary breast lymphoma highlighting the importance of fine needle aspiration cytology as an initial diagnostic tool. J Cytol. 2015;32(2):127-9. doi: 10.4103/0970-9371.160570.
12. Pruthi S, Stafyla VK, Phillips SW, Porrata LF, Reynolds CA. Primary mammary (non-Hodgkin) lymphoma presenting as locally advanced breast cancer. Mayo Clin Proc. 2004;79(10):1310-4. doi: 10.4065/79.10.1310.
13. Sangam S, Naveed A, Athar M, Prathyusha P, Moulika S, Lakshmi S. A study of functional measures in patients with stroke. Int J Health Sci Res. 2015;5(1):156-64.
14. Suzuki Y, Tokuda Y, Okumura A, Saito Y, Ohta M, Kubota M, et al. Three cases of malignant lymphoma of the breast. Jpn J Clin Oncol. 2000;30(1):33-6. doi: 10.1093/jjco/hyd008.
15. Vyas A, Rai NN. A Study of Role of FNAC in Palpable Breast Lump. J Mahatma Gandhi Univ Med Sci Technol. 2018;3(1):1-6. doi: 10.5005/jp-journals-10057-0067.
16. Antonia N, Melani A, Jiménez-Heffernan JA. Cytologic features of abscessified anaplastic large cell lymphoma. J Cytol. 2011;28(2):87-8. doi: 10.4103/0970-9371.80752.
Submitted date:
05/03/2022
Reviewed date:
07/12/2022
Accepted date:
07/31/2022
Publication date:
08/02/2022
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