Primary breast diffuse large B-cell lymphoma: a clinicopathological analysis of four cases / 中华内分泌外科杂志

ABSTRACT

Objective To discuss the clinical pathological features,diagnosis and differential diagnosis,therapy and prognosis of primary breast diffuse large B-cell lymphoma(PB-DLBCL).Methods The clinical manifestations,pathological features,immunophenotypic characteristics of 4 cases of PB-DLBCL were retrospectively reviewed,and related literatures were reviewed.Results All of the 4 patients were women,aged 45 to 69 years,with the median 58.5 years.There were 3 cases of lesions involving the left breast and 1 case of the right breast.Microscopic observation showed that the normal structure of the mammary gland was destroyed,and no capsule was seen.There was a large number of large-to medium-sized heterotypic lymphoid cells which characterized as diffuse infiltration between the remaining ducts or lobules of mammary gland.Tumor cells infiltrated adipose tissue,mainly as central blast-like cells (3 cases) and immunoblast-like cells (1 case).No lymphatic epithelial lesions were observed.The immunophenotype showed 4 cases were non-GCB type.Immunostaining showed that the neoplastic cells were LCA,CD20,CD79a and MUM-1 positive.Ki67 index were from 50％ to 80％.The follow-up time of these cases was until Dec.2017.There was one recurrence during the follow-up period.The patient died 13 months later.One patient was alive and had survived for 66 months.Two patients were lost to follow-up.Conclusions PB-DLBCL is extremely rare,mainly found in women.Most of the cell origin types are non-GCB type,which is often misdiagnosed as breast cancer.The diagnosis of PB-DLBCL is confirmed by pathological biopsy and immunohistochemical markers.The treatment is not clear,and a comprehensive treatment plan such as R-CHOP/ CHOP chemotherapy combined with radiotherapy is recommended.