Kemoterapi ile tedavi edilmiş bir primer meme lenfoması olgusu

Amaç: Memenin primer non-hodgkin lenfoması nadir görülen bir hastalıktır. Bilateral tutulumun daha da nadir görülmesi nedeniyle tartışılması amaçlandı. Olgu: Bilateral primer meme lenfoması teşhis edilen 44 yaşında bir kadın hastayı sunduk. Hastada dört aydır sağ kolda güç kaybı ve bir aydır sağ memede sertlik şikayeti vardı. Yapılan muayenesinde; sağ memede 6x5 cm’lik, sol memede 3x2 cm’lik iki kitle, sağ aksiller bölgede bir adet mobil lenfadenopati ile sağ kolda hareket kısıtlılığı tespit edildi. Meme İİAB’sinde (ince iğne aspirasyon biopsisi) diffüz eritrositler içerisinde hiperkromatinli düzensiz şüpheli hücreler izlendi. Bunun üzerine yapılan eksizyonel biopside Non-hodgkin (intermediate grade diffüz miks tip) lenfoma olduğu görüldü. Hastaya kemoterapi başlandı. Her iki kitlenin de kaybolduğu izlendi. Sonuç: Memenin lenforetiküler malignitelerinin tanısında radyoloji yetersiz kalabilir. İİAB tanı koydurmaz ancak maligniteden şüphelenmeyi sağlar. Sonrasında uygulanan tru-cut veya eksizyonel biopsi ile sonuca ulaşılır. Hastalar kemoterapi ile tedavi edilir.

Anahtar Kelimeler:

Tedavi sonucu, Lenfom, Hodgkin dışı, Meme neoplazmları, Biyopsi, Orta yaşlı, Kadın, Mammografi

A case of primary breast lymphoma treated with chemotherapy

Objective: The primary non Hodgkin lymphoma of breast is a rare disease of the breast. Because of rare occurrence of bilateral disease we aimed to discuss this condition. Case: We present a 44 years old female patient with bilateral primary breast lymphoma. The patient had a history of 4 months of right arm weakness and one month history of mass the in right breast. By examination, 6x5 cm mass in the right, 3x2 cm mass in the left breast were found and a mobile lymph node in the right axilla with restriction of movement in the right arm was detected. The result of fine needle aspiration biopsy (FNAB) revealed diffuse hyperchromatic irregular suspicious cells in between erythrocytes. By exisional biopsy the pathology revealed Non-Hodgkin’s Lymphoma (intermediate grade diffuse mixed type). Chemotherapy was started. We found that both breast masses were disappeared. Conclusion: The radiological investigations may be insufficient for the diagnosis of lymphoreticuler malignancies of breast. FNAB can only make suspicion of the malignancy and may be insufficient in diagnosis. However, Tru-Cut biopsy or exisional biopsy help us to reach the diagnosis. The patients can be treated by chemotherapy.

Keywords:

Treatment Outcome, Lymphoma, Non-Hodgkin, Breast Neoplasms, Biopsy, Middle Aged, Female, Mammography,

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1. Hugh JC, Jackson FI, Hanson J, Poppema S. Primary breast lymphoma. An immunohistologic study of 20 new cases. Cancer 1990; 66:2602-11.
2. Lamovec J, Jancar J. Primary malignant lymphoma of the breast. Lymphoma of the mucosa-associated lymphoid tissue. Cancer 1987;115:3033-41.
3. Isaacson P, Wright DH. Extranodal malignant lymphoma arising from mucosa-associated lymphoid tissue. Cancer 1984;53:2515-24.
4. Brogi E, Harris NL. Lymphomas of the breast: Pathology and clinical behavior. Semin Oncol 1999;26:357-64.
5. Lin Y, Govindan R, Hess JL. Malignant hematopoietic breast tumors. Am J Clin Pathol 1997;107:177-86.
6. Akbari CM, Welch JP, Pastuszak W. Primary lymphoproliferative disorders of the breast. Conn Med 1995;59:651-5.
7. Gupta D, Shidham V, Zemba-Palko V, Keshgegian A. Primary bilateral mucosa-associated lymphoid tissue lymphoma of the breast with atypical ductal hyperplasia and localized amyloidosis. A case report and review of the literature. Arch Pathol Lab Med 2000;124:1233-6.
8. Babovic N, Jelic S, Jovanovic V. Primary non-Hodgkin lymphoma of the breast. Is it possible to avoid mastectomy? J Exp Clin Cancer Res 2000;19:149-54.
9. Ferguson DJ. Intraepithelial lymphocytes and macrophages in the normal breast. Virchows Arch A Pathol Anat Histopathol 1985;407:369-78.
10. Schouten JT, Weese JL, Carbone PP. Lymphoma of the breast. Ann Surg 1981;194:749-53.
11. Cohen PL, Brooks JJ. Lymphomas of the breast. A clinicopathologic and immunohistochemical study of primary and secondary cases. Cancer 199;67:1359-69.
12. Topalovski M, Crisan D, Mattson JC. Lymphoma of the breast. A clinicopathologic study of primary and secondary cases. Arch Pathol Lab Med. 1999;123:1208-18.
13. Dawn B, Perry MC. Bilateral non-Hodgkin's lymphoma of the breast mimicking mastitis. South Med J 1997;90:328-9.