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Lymphoma, Primary Breast
Jessica W. T. Leung, MD; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Primary breast lymphoma (PBL)
              • Mucosa-associated lymphoid tissue (MALT)
            • Definitions

              • Clonal population of malignant lymphocytes involving breast ± axillary lymph node(s) in absence of extramammary disease
                • Breast parenchymal lesion required for diagnosis
              • Diagnosis based on Wiseman and Liao criteria
                • Close association of mammary tissue with lymphomatous infiltrate
                • No evidence of systemic lymphoma or previous extramammary lymphoma at time of diagnosis
                • Restricted to breast &/or ipsilateral axillary lymph nodes at time of diagnosis
                • Technically adequate pathologic sample

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Image-Guided Biopsy

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Peñalver FJ et al: Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO). Haematologica. 102(2):235-245, 2017
                                            2. Wienbeck S et al: Radiological imaging characteristics of intramammary hematological malignancies: results from a german multicenter study. Sci Rep. 7(1):7435, 2017
                                            3. Dong A et al: Spectrum of the breast lesions with increased 18F-FDG uptake on PET/CT. Clin Nucl Med. 41(7):543-57, 2016
                                            4. Nicholson BT et al: Extranodal lymphoma of the breast. Radiol Clin North Am. 54(4):711-26, 2016
                                            5. Gkali CA et al: Primary non-Hodgkin lymphoma of the breast: Ultrasonography, elastography, digital mammography, contrast-enhanced digital mammography, and pathology findings. Ultrasound Q. 31(4):279-82, 2015
                                            6. Wang L et al: MRI features of breast lymphoma: preliminary experience in seven cases. Diagn Interv Radiol. 21(6):441-7, 2015
                                            7. Cheah CY et al: Primary breast lymphoma. Cancer Treat Rev. 40(8):900-8, 2014
                                            8. Larribe M et al: Breast cancers with round lumps: correlations between imaging and anatomopathology. Diagn Interv Imaging. 95(1):37-46, 2014
                                            9. Radkani P et al: Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg. 149(1):91-3, 2014
                                            10. Aviv A et al: Primary diffuse large B-cell lymphoma of the breast: looking at pathogenesis, clinical issues and therapeutic options. Ann Oncol. 24(9):2236-44, 2013
                                            11. Liu K et al: The features of breast lymphoma on MRI. Br J Radiol. 86(1031):20130220, 2013
                                            12. Matsubayashi RN et al: MR imaging of malignant primary breast lymphoma: including diffusion-weighted imaging, histologic features, and a literature review. Jpn J Radiol. 31(10):668-76, 2013
                                            13. Caon J et al: Treatment and outcomes of primary breast lymphoma. Clin Breast Cancer. 12(6):412-9, 2012
                                            14. Ikeda T et al: Malignant lymphoma of the breast in a male patient: ultrasound imaging features. Breast Cancer. Epub ahead of print, 2012
                                            15. Surov A et al: Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features. Br J Radiol. 85(1014):e195-205, 2012
                                            16. Ginat DT et al: FDG PET/CT manifestations of hematopoietic malignancies of the breast. Acad Radiol. 17(8):1026-30, 2010
                                            17. Broyde A et al: Role and prognostic significance of the Ki-67 index in non-Hodgkin's lymphoma. Am J Hematol. 84(6):338-43, 2009
                                            18. Rizzo S et al: Magnetic resonance imaging of primary breast lymphoma. Radiol Med. 114(6):915-24, 2009
                                            19. Kuroda H et al: Primary diffuse large B-cell lymphoma of the breast. Breast Cancer. 14(3):317-22, 2007
                                            20. Lyou CY et al: Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging. 31(4):234-8, 2007
                                            21. Woo OH et al: Synchronous bilateral primary breast lymphoma: MRI and pathologic findings. Breast J. 13(4):429-30, 2007
                                            22. Yang WT et al: Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology. 245(3):692-702, 2007
                                            23. Areia AL et al: Primary breast lymphoma. Eur J Gynaecol Oncol. 26(2):163-4, 2005
                                            24. Baker R et al: Multifocal primary breast lymphoma. South Med J. 98(10):1045-8, 2005
                                            25. Espinosa LA et al: MRI features of mucosa-associated lymphoid tissue lymphoma in the breast. AJR Am J Roentgenol. 185(1):199-202, 2005
                                            26. Fruchart C et al: High grade primary breast lymphoma: is it a different clinical entity? Breast Cancer Res Treat. 93(3):191-8, 2005
                                            27. Grubstein A et al: Extranodal primary B-cell non-Hodgkin lymphoma of the breast mimicking acute mastitis. J Clin Ultrasound. 33(3):140-2, 2005
                                            28. Kebudi A et al: Primary T-lymphoma of the breast with bilateral involvement, unusual presentation. Int J Clin Pract Suppl. (147):95-8, 2005
                                            29. Kumar R et al: F-18 FDG positron emission tomography in non-Hodgkin lymphoma of the breast. Clin Nucl Med. 30(4):246-8, 2005
                                            30. Liu MT et al: Primary breast lymphoma: a pooled analysis of prognostic factors and survival in 93 cases. Ann Saudi Med. 25(4):288-93, 2005
                                            31. Maounis N et al: Bilateral primary lymphoma of the breast: a case report initially diagnosed by FNAC. Diagn Cytopathol. 32(2):114-8, 2005
                                            32. Mason HS et al: Primary breast lymphoma: radiologic and pathologic findings. Breast J. 11(6):495-6, 2005
                                            33. Vardar E et al: Primary breast lymphoma cytologic diagnosis. Arch Pathol Lab Med. 129(5):694-6, 2005
                                            34. Venizelos ID et al: Primary non-Hodgkin's lymphoma arising in an intramammary lymph node. Leuk Lymphoma. 46(3):451-5, 2005
                                            35. Vignot S et al: Non-Hodgkin's lymphoma of the breast: a report of 19 cases and a review of the literature. Clin Lymphoma. 6(1):37-42, 2005
                                            36. Carrascosa LA et al: Synchronous primary bilateral breast lymphoma. Am J Clin Oncol. 27(6):635, 2004
                                            37. Loughrey MB et al: WHO reclassification of breast lymphomas. J Clin Pathol. 57(11):1213-4, 2004
                                            38. Mpallas G et al: Primary breast lymphoma in a male patient. Breast. 13(5):436-8, 2004
                                            39. Pruthi S et al: Primary mammary (non-Hodgkin) lymphoma presenting as locally advanced breast cancer. Mayo Clin Proc. 79(10):1310-4, 2004
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Primary breast lymphoma (PBL)
                                                        • Mucosa-associated lymphoid tissue (MALT)
                                                      • Definitions

                                                        • Clonal population of malignant lymphocytes involving breast ± axillary lymph node(s) in absence of extramammary disease
                                                          • Breast parenchymal lesion required for diagnosis
                                                        • Diagnosis based on Wiseman and Liao criteria
                                                          • Close association of mammary tissue with lymphomatous infiltrate
                                                          • No evidence of systemic lymphoma or previous extramammary lymphoma at time of diagnosis
                                                          • Restricted to breast &/or ipsilateral axillary lymph nodes at time of diagnosis
                                                          • Technically adequate pathologic sample

                                                      IMAGING

                                                      • General Features

                                                        • Mammographic Findings

                                                          • Ultrasonographic Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Image-Guided Biopsy

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Peñalver FJ et al: Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO). Haematologica. 102(2):235-245, 2017
                                                                                      2. Wienbeck S et al: Radiological imaging characteristics of intramammary hematological malignancies: results from a german multicenter study. Sci Rep. 7(1):7435, 2017
                                                                                      3. Dong A et al: Spectrum of the breast lesions with increased 18F-FDG uptake on PET/CT. Clin Nucl Med. 41(7):543-57, 2016
                                                                                      4. Nicholson BT et al: Extranodal lymphoma of the breast. Radiol Clin North Am. 54(4):711-26, 2016
                                                                                      5. Gkali CA et al: Primary non-Hodgkin lymphoma of the breast: Ultrasonography, elastography, digital mammography, contrast-enhanced digital mammography, and pathology findings. Ultrasound Q. 31(4):279-82, 2015
                                                                                      6. Wang L et al: MRI features of breast lymphoma: preliminary experience in seven cases. Diagn Interv Radiol. 21(6):441-7, 2015
                                                                                      7. Cheah CY et al: Primary breast lymphoma. Cancer Treat Rev. 40(8):900-8, 2014
                                                                                      8. Larribe M et al: Breast cancers with round lumps: correlations between imaging and anatomopathology. Diagn Interv Imaging. 95(1):37-46, 2014
                                                                                      9. Radkani P et al: Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg. 149(1):91-3, 2014
                                                                                      10. Aviv A et al: Primary diffuse large B-cell lymphoma of the breast: looking at pathogenesis, clinical issues and therapeutic options. Ann Oncol. 24(9):2236-44, 2013
                                                                                      11. Liu K et al: The features of breast lymphoma on MRI. Br J Radiol. 86(1031):20130220, 2013
                                                                                      12. Matsubayashi RN et al: MR imaging of malignant primary breast lymphoma: including diffusion-weighted imaging, histologic features, and a literature review. Jpn J Radiol. 31(10):668-76, 2013
                                                                                      13. Caon J et al: Treatment and outcomes of primary breast lymphoma. Clin Breast Cancer. 12(6):412-9, 2012
                                                                                      14. Ikeda T et al: Malignant lymphoma of the breast in a male patient: ultrasound imaging features. Breast Cancer. Epub ahead of print, 2012
                                                                                      15. Surov A et al: Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features. Br J Radiol. 85(1014):e195-205, 2012
                                                                                      16. Ginat DT et al: FDG PET/CT manifestations of hematopoietic malignancies of the breast. Acad Radiol. 17(8):1026-30, 2010
                                                                                      17. Broyde A et al: Role and prognostic significance of the Ki-67 index in non-Hodgkin's lymphoma. Am J Hematol. 84(6):338-43, 2009
                                                                                      18. Rizzo S et al: Magnetic resonance imaging of primary breast lymphoma. Radiol Med. 114(6):915-24, 2009
                                                                                      19. Kuroda H et al: Primary diffuse large B-cell lymphoma of the breast. Breast Cancer. 14(3):317-22, 2007
                                                                                      20. Lyou CY et al: Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging. 31(4):234-8, 2007
                                                                                      21. Woo OH et al: Synchronous bilateral primary breast lymphoma: MRI and pathologic findings. Breast J. 13(4):429-30, 2007
                                                                                      22. Yang WT et al: Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology. 245(3):692-702, 2007
                                                                                      23. Areia AL et al: Primary breast lymphoma. Eur J Gynaecol Oncol. 26(2):163-4, 2005
                                                                                      24. Baker R et al: Multifocal primary breast lymphoma. South Med J. 98(10):1045-8, 2005
                                                                                      25. Espinosa LA et al: MRI features of mucosa-associated lymphoid tissue lymphoma in the breast. AJR Am J Roentgenol. 185(1):199-202, 2005
                                                                                      26. Fruchart C et al: High grade primary breast lymphoma: is it a different clinical entity? Breast Cancer Res Treat. 93(3):191-8, 2005
                                                                                      27. Grubstein A et al: Extranodal primary B-cell non-Hodgkin lymphoma of the breast mimicking acute mastitis. J Clin Ultrasound. 33(3):140-2, 2005
                                                                                      28. Kebudi A et al: Primary T-lymphoma of the breast with bilateral involvement, unusual presentation. Int J Clin Pract Suppl. (147):95-8, 2005
                                                                                      29. Kumar R et al: F-18 FDG positron emission tomography in non-Hodgkin lymphoma of the breast. Clin Nucl Med. 30(4):246-8, 2005
                                                                                      30. Liu MT et al: Primary breast lymphoma: a pooled analysis of prognostic factors and survival in 93 cases. Ann Saudi Med. 25(4):288-93, 2005
                                                                                      31. Maounis N et al: Bilateral primary lymphoma of the breast: a case report initially diagnosed by FNAC. Diagn Cytopathol. 32(2):114-8, 2005
                                                                                      32. Mason HS et al: Primary breast lymphoma: radiologic and pathologic findings. Breast J. 11(6):495-6, 2005
                                                                                      33. Vardar E et al: Primary breast lymphoma cytologic diagnosis. Arch Pathol Lab Med. 129(5):694-6, 2005
                                                                                      34. Venizelos ID et al: Primary non-Hodgkin's lymphoma arising in an intramammary lymph node. Leuk Lymphoma. 46(3):451-5, 2005
                                                                                      35. Vignot S et al: Non-Hodgkin's lymphoma of the breast: a report of 19 cases and a review of the literature. Clin Lymphoma. 6(1):37-42, 2005
                                                                                      36. Carrascosa LA et al: Synchronous primary bilateral breast lymphoma. Am J Clin Oncol. 27(6):635, 2004
                                                                                      37. Loughrey MB et al: WHO reclassification of breast lymphomas. J Clin Pathol. 57(11):1213-4, 2004
                                                                                      38. Mpallas G et al: Primary breast lymphoma in a male patient. Breast. 13(5):436-8, 2004
                                                                                      39. Pruthi S et al: Primary mammary (non-Hodgkin) lymphoma presenting as locally advanced breast cancer. Mayo Clin Proc. 79(10):1310-4, 2004