Ciência e terapia do câncer

Primary Breast Lymphoma: Exceptional Lesion with Particular Management

Abstract

Olfa El Amine El Hadj, Azza Gabsi, Aida Goucha, Meyssa Belghith, Khaled Rahal and Amor Gamoudi

Introduction: Non-Hodgkin’s primary lymphoma of the breast is a rare entity. These tumors represent 0.04% to 0.52% of malignant breast pathology, 2.2% of extranodal lymphoma and 0.4% of all non-Hodgkin lymphoma. Clinical and radiological aspects show no special characteristics. The diagnosis is based on the presence of a lymphomatous proliferation strongly associated to the breast tissue and the diagnosis of an extra-mammary lymphoma must be removed except the presence of ipsilateral axillary lymphadenopathy.

Patients and methods: This is a retrospective study of 9 patients treated for non-Hodgkin’s primary lymphoma of the breast. They were collected over a period of 14 years (2000-2013). They interested 1 case of follicular lymphoma, 1 case of large T-cell lymphoma and 7 cases of large B-cell lymphoma. The average age was 50 years, ranging from 30 to 76 years. The sex ratio was 0.11 (1 man/8 women). The median follow-up was 43 months (4-192). Six patients were older than 60 years. All the tumors were architecturally diffuse. The overall survival was 100% at one year 60% at 3 years. Seven patients achieved a complete remission after initial treatment; one had relapsed after 2 months. Among the 7 cases of large B cell lymphoma, two cases result from follicular lymphoma’s transformation. The average processing time was 17 months.

Conclusion: The primary breast lymphoma is often diagnosed late. Treatment should be rapidly implemented. Indeed, the 5-year survival of stage I of the Ann Arbor classification is better than for stage II.