Recurrent Primary Breast Lymphoma in Nipple of the Same Side after Surgery: Report of One Case_West China Medical Journal

Authors：

LI Zhifeng ¹ , CHEN Jianxin ¹ , CHANG Renan ² ,  CHEN Zhong ²

1. Department of Surgery, Affiliated Maternal and Infant Hospital of Nantong University, Nantong 226001, P. R. China; 2. Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong 226001, P. R. China;

Corresponding?author：

CHEN Zhong, Email: dr-lizhifeng@hotmail.com

Keywords：

乳腺; 原發性淋巴瘤; 復發

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【摘要】　目的　總結原發性乳腺淋巴瘤（primary breast lymphoma，PBL）的臨床病理學、免疫組織化學特征、綜合治療及復發情況。　方法　對2010年11月入院手術切除的PBL術后同側乳頭復發的1例患者的臨床資料進行回顧分析，病理常規切片及免疫組織化學觀察。　結果　光學顯微鏡檢查低倍鏡下腫瘤細胞彌漫性浸潤破壞乳頭組織，導致乳頭結構紊亂，腫塊乳管結構紊亂；高倍鏡下顯示瘤細胞成分多樣，以中等大小細胞和大細胞為主，腫瘤細胞彌漫侵犯小血管。免疫組織化學結果顯示Ki-67（ gt;90%），CD20（+），bcl-6（+），MUM1（+），CD43（灶+），CD3（-），CD10（-）。符合惡性非霍奇金淋巴瘤。　結論　 PBL是一種少見的結外淋巴瘤，臨床表現缺乏特異性，術前很難與乳腺其他良、惡性病變區分，其診斷主要依靠術后病理。目前單純腫塊切除術+放射治療聯合全身化學療法是治療PBL臨床共識，腫瘤復發可能與Ki-67高度表達存在相關性。
【Abstract】　Objective　 To investigate the clinical pathology, immunohistochemical features, comprehensive treatment, recurrence and prognosis of primary breast lymphoma (PBL).　Methods　 We retrospectively analyzed the clinical data including general information and pathological and immnohistochemical examinations of one patient with recurrent PBL in nipple of the same side after surgery who was admitted into our hospital in November 2010.　Results　 Under low-power optical microscope lens, we found that the tumor cells diffused and infiltrated the nipple tissue which looked quite disorganized. Under high-power lens, we observed various tumor cells, especially the medium-and large-sized tumor cells which infiltrated small vessels. The results of immunohistochemical tests were as follows: Ki-67 ( gt;90%), CD20 (+), bcl-6 (+), MUM1 (+), CD43 (nidus+), CD3 (-), and CD10 (-). All these indexes indicated malignant non-Hodgkin’s lymphoma.　Conclusions　 PBL is a kind of extremely rare extra-nodal lymphoma with low-specificity clinical manifestations, and it is hard to distinguish from other mammary abnormalities. Its diagnosis mainly depends on pathological examinations. At present, lumpectomy followed by chemotherapy and radiotherapy is the best treatment method. Its recurrence may be related to the high expression of Ki-67.

Citation： LI Zhifeng,CHEN Jianxin,CHANG Renan,CHEN Zhong. Recurrent Primary Breast Lymphoma in Nipple of the Same Side after Surgery: Report of One Case. West China Medical Journal, 2011, 26(7): 992-994. doi: Copy

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11.	齊曉偉, 姜軍. 原發性乳腺淋巴瘤的手術治療效果評估及淋巴結狀況對治療方案選擇的重要性[J/CD]. 中華乳腺病雜志(電子版), 2007, 1(5): 81-83.
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1. 　茅楓, 孫強, 周易冬, 等. 原發性乳腺淋巴瘤8例臨床分析[J]. 中國腫瘤臨床與康復, 2010, 17(3): 245-246.
2. 　Kuper-Hommel MJ, Snijder S, Janssen-Heijnen ML, et al. Treatment and survival of 38 female breast lymphomas: a population-based study with clinical and pathological reviews[J]. Ann Hematol, 2003, 82(7): 397-404.
3. 　Ryan GF, Roos DR, Seymour JF. Primary non-Hodgkin’s lymphoma of the breast: retrospective analysis of prognosis and patterns of failure in two Australian centers [J]. Clin Lymphoma Myeloma, 2006, 6(4):337-341.
4. 　張玉晶, 夏云飛, 崔念基, 等. 乳腺原發性惡性淋巴瘤的診斷及治療[J]. 山東醫藥, 2004, 44(36): 11-12.
5. 　王黎明, 張海增, 邵永孚. 原發性乳腺惡性淋巴瘤 21 例臨床分析[J]. 實用癌癥雜志, 2004, 19(4): 401-402.
6. 　Duncan VE, Reddv VV, Jhala NC, et al. Non-Hodgkin lymphoma of the breast: a review of 18 primary and secondary cases[J]. Ann Diagn Pathol, 2006, 10(3): 144-148.
7. 　Ott G, Katzenberger T, Greiner A, et al. The t(11;18)(q21;q21) chromosome translocation is a frequent and specific aberration in low-grade but not high-grade malignant non-Hodgkin lymphomas of the mucosa-associated lymphoid tissue (MALT) type [J]. Cancer Res, 1997, 57 (18): 3944-3948.
8. 　季永領, 朱慧能, 鄧清華, 等. 原發性乳腺淋巴瘤 16 例臨床分析[J]. 腫瘤學雜志, 2006, 12(4): 314-316.
9. 　Wiseman C, Liao KT. Primary lymphoma of the breast[J]. Cancer, 1972, 29(6): 1705-1712.
10. 　Vigliotti ML, Dellolio M, La Sala A, et al. Primary breast lymphoma: outcome of 7 patients and a review of the literature [J]. Leuk Lymphoma, 2005, 46(9): 1321-1327.
11. 　齊曉偉, 姜軍. 原發性乳腺淋巴瘤的手術治療效果評估及淋巴結狀況對治療方案選擇的重要性[J/CD]. 中華乳腺病雜志(電子版), 2007, 1(5): 81-83.
12. 　Avilés A, Delgado S, Nambo MJ, et al. Primary breast lymphoma: results of a controlled clinical trial[J]. Oncology, 2005, 69(3): 256-260.
13. 　Wong WW, Schild SE, Halyard MY, et al. Primary non-Hodgkin lymphoma of the breast: the Mayo clinic experience[J]. J Surg Oncol, 2002, 80(1): 19-25.

West China Medical Journal

Recurrent Primary Breast Lymphoma in Nipple of the Same Side after Surgery: Report of One Case

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