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Breast
Special Topics
Breast Manifestations of Systemic Conditions
Lymphoma, Secondary
Lymphoma, Secondary
Melissa Durand, MD; Wendie A. Berg, MD, PhD, FACR, FSBI; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Non-Hodgkin lymphoma (NHL)

            • Definitions

              • Clonal population of malignant lymphocytes involving breast
              • 2 distinct entities
                • Primary breast lymphoma
                  • Restricted to breast parenchyma ± axillary nodes at diagnosis without previous known lymphoma
                • Secondary (metastatic) lymphoma involving breast
                  • Breast ± axillary node involvement in patient with concurrent or prior systemic lymphoma
              • Rare, < 0.5% of breast malignancies; ~ 5% of extranodal lymphomas; more common than primary breast lymphoma

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        • CT Findings

                          • Image-Guided Biopsy

                            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. Ollila TA et al: Extranodal diffuse large B-cell lymphoma: molecular features, prognosis, and risk of central nervous system recurrence. Curr Treat Options Oncol. 19(8):38, 2018
                                              2. Alsadi A et al: Hematologic malignancies discovered on investigation of breast abnormalities. South Med J. 110(10):614-20, 2017
                                              3. Hoffmann J et al: Hematolymphoid lesions of the breast. Semin Diagn Pathol. 34(5):462-9, 2017
                                              4. Marinopoulos S et al: Breast lymphoma in a patient with B-cell non-Hodgkin lymphoma: a case report study. Int J Surg Case Rep. 40:1-5, 2017
                                              5. Wienbeck S et al: Radiological imaging characteristics of intramammary hematological malignancies: results from a German multicenter study. Sci Rep. 7(1):7435, 2017
                                              6. Nicholson BT et al: Extranodal lymphoma of the breast. Radiol Clin North Am. 54(4):711-26, 2016
                                              7. Sousaris N et al: Sonoelastography of breast lymphoma. Ultrasound Q. 32(3):208-11, 2016
                                              8. Ikeda T et al: Malignant lymphoma of the breast in a male patient: ultrasound imaging features. Breast Cancer. 22(2):201-5, 2015
                                              9. Glazebrook KN et al: Breast imaging findings in haematological malignancies. Insights Imaging. 5(6):715-22, 2014
                                              10. Surov A et al: Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features. Br J Radiol. 85(1014):e195-205, 2012
                                              11. Ilica AT et al: Imaging of extranodal lymphoma with PET/CT. Clin Nucl Med. 36(10):e127-38, 2011
                                              12. Thomas AG et al: Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol. 197(2):357-64, 2011
                                              13. Ginat DT et al: FDG PET/CT manifestations of hematopoietic malignancies of the breast. Acad Radiol. 17(8):1026-30, 2010
                                              14. Ng A et al: ACR Appropriateness Criteria: follow-up of Hodgkin's lymphoma. Curr Probl Cancer. 34(3):211-27, 2010
                                              15. Chua SC et al: Imaging features of primary extranodal lymphomas. Clin Radiol. 64(6):574-88, 2009
                                              16. Rizzo S et al: Magnetic resonance imaging of primary breast lymphoma. Radiol Med. 114(6):915-24, 2009
                                              17. Talwalkar SS et al: Lymphomas involving the breast: a study of 106 cases comparing localized and disseminated neoplasms. Am J Surg Pathol. 32(9):1299-309, 2008
                                              18. Kuroda H et al: Primary diffuse large B-cell lymphoma of the breast. Breast Cancer. 14(3):317-22, 2007
                                              19. Lyou CY et al: Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging. 31(4):234-8, 2007
                                              20. Woo OH et al: Synchronous bilateral primary breast lymphoma: MRI and pathologic findings. Breast J. 13(4):429-30, 2007
                                              21. Yang WT et al: Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology. 245(3):692-702, 2007
                                              22. 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
                                              23. 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
                                              24. 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
                                              25. Loughrey MB et al: WHO reclassification of breast lymphomas. J Clin Pathol. 57(11):1213-4, 2004
                                              26. Mattia AR et al: Breast lymphoma. A B-cell spectrum including the low grade B-cell lymphoma of mucosa associated lymphoid tissue. Am J Surg Pathol. 17(6):574-87, 1993
                                              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

                                                          • Non-Hodgkin lymphoma (NHL)

                                                        • Definitions

                                                          • Clonal population of malignant lymphocytes involving breast
                                                          • 2 distinct entities
                                                            • Primary breast lymphoma
                                                              • Restricted to breast parenchyma ± axillary nodes at diagnosis without previous known lymphoma
                                                            • Secondary (metastatic) lymphoma involving breast
                                                              • Breast ± axillary node involvement in patient with concurrent or prior systemic lymphoma
                                                          • Rare, < 0.5% of breast malignancies; ~ 5% of extranodal lymphomas; more common than primary breast lymphoma

                                                        IMAGING

                                                        • General Features

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • MR Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    • CT Findings

                                                                      • Image-Guided Biopsy

                                                                        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. Ollila TA et al: Extranodal diffuse large B-cell lymphoma: molecular features, prognosis, and risk of central nervous system recurrence. Curr Treat Options Oncol. 19(8):38, 2018
                                                                                          2. Alsadi A et al: Hematologic malignancies discovered on investigation of breast abnormalities. South Med J. 110(10):614-20, 2017
                                                                                          3. Hoffmann J et al: Hematolymphoid lesions of the breast. Semin Diagn Pathol. 34(5):462-9, 2017
                                                                                          4. Marinopoulos S et al: Breast lymphoma in a patient with B-cell non-Hodgkin lymphoma: a case report study. Int J Surg Case Rep. 40:1-5, 2017
                                                                                          5. Wienbeck S et al: Radiological imaging characteristics of intramammary hematological malignancies: results from a German multicenter study. Sci Rep. 7(1):7435, 2017
                                                                                          6. Nicholson BT et al: Extranodal lymphoma of the breast. Radiol Clin North Am. 54(4):711-26, 2016
                                                                                          7. Sousaris N et al: Sonoelastography of breast lymphoma. Ultrasound Q. 32(3):208-11, 2016
                                                                                          8. Ikeda T et al: Malignant lymphoma of the breast in a male patient: ultrasound imaging features. Breast Cancer. 22(2):201-5, 2015
                                                                                          9. Glazebrook KN et al: Breast imaging findings in haematological malignancies. Insights Imaging. 5(6):715-22, 2014
                                                                                          10. Surov A et al: Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features. Br J Radiol. 85(1014):e195-205, 2012
                                                                                          11. Ilica AT et al: Imaging of extranodal lymphoma with PET/CT. Clin Nucl Med. 36(10):e127-38, 2011
                                                                                          12. Thomas AG et al: Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol. 197(2):357-64, 2011
                                                                                          13. Ginat DT et al: FDG PET/CT manifestations of hematopoietic malignancies of the breast. Acad Radiol. 17(8):1026-30, 2010
                                                                                          14. Ng A et al: ACR Appropriateness Criteria: follow-up of Hodgkin's lymphoma. Curr Probl Cancer. 34(3):211-27, 2010
                                                                                          15. Chua SC et al: Imaging features of primary extranodal lymphomas. Clin Radiol. 64(6):574-88, 2009
                                                                                          16. Rizzo S et al: Magnetic resonance imaging of primary breast lymphoma. Radiol Med. 114(6):915-24, 2009
                                                                                          17. Talwalkar SS et al: Lymphomas involving the breast: a study of 106 cases comparing localized and disseminated neoplasms. Am J Surg Pathol. 32(9):1299-309, 2008
                                                                                          18. Kuroda H et al: Primary diffuse large B-cell lymphoma of the breast. Breast Cancer. 14(3):317-22, 2007
                                                                                          19. Lyou CY et al: Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging. 31(4):234-8, 2007
                                                                                          20. Woo OH et al: Synchronous bilateral primary breast lymphoma: MRI and pathologic findings. Breast J. 13(4):429-30, 2007
                                                                                          21. Yang WT et al: Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology. 245(3):692-702, 2007
                                                                                          22. 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
                                                                                          23. 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
                                                                                          24. 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
                                                                                          25. Loughrey MB et al: WHO reclassification of breast lymphomas. J Clin Pathol. 57(11):1213-4, 2004
                                                                                          26. Mattia AR et al: Breast lymphoma. A B-cell spectrum including the low grade B-cell lymphoma of mucosa associated lymphoid tissue. Am J Surg Pathol. 17(6):574-87, 1993