Frequency and characteristics of breast lymphomas presenting to a tertiary care hospital Pakistan

ABSTRACT

To assess the relative frequency of [primary and secondary] mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms. All NHLs [nodal and extra nodal] diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients [n=30] diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information. A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total number of NHLs [Nodal and extra Nodal] was 2632. Thirty [n=30] patients accounting for 1.13% were diagnosed to have lymphomatous involvement of the breast. The Female to Male ratio was13.51; age range was 12-92 years with a median age of 43 years [Mean age 46.5 years and Standard deviation of age was 16.88 years]. The sites of the lesions were the right breast in 11 cases [37.93%], left breast in 9 cases [31.03%] and both breasts in 2 cases [6.89%], while the location of 8 masses [27.58%] was unknown. Immunohistochemical studies were negative for cytokeratins [MNF and Cam 5.2] in all cases. All cases of DLBCL expressed B cell lineage antigens and were positive for LCA and Pan B [CD20 and 79a]. We concluded that breast lymphomas represent 1.13% of all NHL and 0.5% of all breast malignancies in this study. The most frequent morphologic type was diffuse large B-cell lymphoma. As patients with primary breast lymphoma have a better prognosis than those with carcinoma of the breast or patients with extranodal lymphomas, a multidisciplinary approach including surgery, radiotherapy, and chemotherapy when needed would result in a more favourable outcome: