Linfoma no Hodgkin estadio IV con metástasis mamaria y vaginal / Non Hodgkin lymphoma stage IV with breast and vaginal metastasis

Resumen ANTECEDENTES: La afectación mamaria por un linfoma es poco frecuente; casi siempre se trata de linfomas tipo B que se caracterizan por falta de especificidad clínica y radiológica, lo que dificulta el diagnóstico diferencial con tumoraciones mamarias de otro origen. CASO CLÍNICO: Paciente de 72 años de edad, con antecedentes de hipercolesterolemia, hipertensión arterial, artrosis y depresión, con dos partos y menopausia a los 55 años. Madre con antecedente de cáncer de mama posmenopáusico. En la mamografía de la mama derecha se encontró una masa retroareolar de 8 cm, de contornos mal definidos y una adenopatía axilar con engrosamiento cortical. La biopsia reportó un linfoma no Hodgkin B de alto grado. Se administraron 8 ciclos de quimioterapia con el esquema R-CHOP. Luego de este esquema el PET-TC mostró una lesión mamaria derecha residual, metabólicamente inactiva, sin enfermedad nodal ni extramamaria supra ni infradiafragmática. CONCLUSIONES: Una neoplasia maligna mamaria no siempre se trata de un carcinoma ductal o lobulillar. Es necesario valorar la posibilidad de otras estirpes histológicas o, incluso, de una afectación metastásica. La entrevista y exploración adecuadas son fundamentales para una buena orientación diagnóstica.

Abstract BACKGROUND: The mammary affectation by a lymphoma is not frequent; it almost always involves type B lymphomas. It is characterized by a lack of clinical and radiological specificity, which makes differential diagnosis difficult with mammary tumors of another origin. CLINICAL CASE: A 72-year-old patient with a history of hypercholesterolemia, hypertension, osteoarthritis and depression, with two deliveries and menopause at 55 years of age. Mother with a history of postmenopausal breast cancer. The mammography of the right breast reported the existence of a retroareolar mass of 8 cm, of ill-defined contours and an axillary adenopathy with cortical thickening. The biopsy reported a high-grade non-Hodgkin B lymphoma. 8 cycles of chemotherapy were administered with the R-CHOP scheme. After this procedure, the PET-CT showed a residual, metabolically inactive right mammary lesion, with nodal or extramammary supra or infradiaphragmatic disease. CONCLUSIONS: A malignant mammary neoplasm is not always a ductal or lobular carcinoma. It is necessary to evaluate the possibility of other histological strains or, even, of a metastatic affectation. The adequate interview and exploration are fundamental for a good diagnostic orientation.

Association of CYP2C19 gene polymorphism with anastrozole in treatment of postmenopausal breast can-cer patients / 实用医学杂志

Objective To investigate the correlation between CYP2C19*2 gene polymorphism and efficacy of anastrozole in postmenopausal women with breast cancer. Methods The polymorphisms of CYP2C19*2 gene in postmenopausal women with postmenopausal breast cancer were detected by PCR. Results The A allele frequency of the CYP2C19*2 gene(OR=3.146,95% CI:1.244~7.275,P<0.05)was a risk factor for the efficacy of post-menopausal breast cancer patients.The survival rate was lower than that of GG(χ2=6.26,P<0.05).After treat-ment,the FSH and LH of GG patients were significantly lower than those of AA and GA(t=5.29,6.47,P<0.05). Multivariate logistic regression analysis showed that anastrozoleand CYP2C19*2 gene polymorphism were indepen-dently associated with serum FSH and LH levels in postmenopausal women with breast. Conclusion CYP2C19*2 gene polymorphism is associated with anastrozole in the treatment of postmenopausal breast cancer.