Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features

• Published in: British journal of radiology Vol. 85; no. 1014; pp. e195 - e205
• Main Authors: Surov, A, Holzhausen, H-J, Wienke, A, Schmidt, J, Thomssen, C, Arnold, D, Ruschke, K, Spielmann, R-P
• Format: Journal Article
• Language: English
• Published: England The British Institute of Radiology 01.06.2012
• Subjects: Adult; Aged; Aged, 80 and over; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - epidemiology; Breast Neoplasms - secondary; Breast Neoplasms, Male - diagnosis; Breast Neoplasms, Male - diagnostic imaging; Breast Neoplasms, Male - epidemiology; Female; Humans; Lymphoma, B-Cell - diagnosis; Lymphoma, B-Cell - diagnostic imaging; Lymphoma, B-Cell - epidemiology; Lymphoma, T-Cell - diagnosis; Lymphoma, T-Cell - diagnostic imaging; Lymphoma, T-Cell - epidemiology; Magnetic Resonance Imaging; Male; Mammography; Middle Aged; Prevalence; Retrospective Studies; Ultrasonography; Young Adult
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/78413721

The purpose of this study was to determine the prevalence, clinical signs and radiological features of breast lymphoma. This is a retrospective review of 36 patients with breast lymphoma (22 primary and 14 secondary). 35 patients were female and 1 was male; their median age was 65 years (range 24-88 years). In all patients, the diagnosis was confirmed histopathologically. The prevalence of breast lymphoma was 1.6% of all identified cases with non-Hodgkin lymphoma and 0.5% of cases with breast cancer. B-cell lymphoma was found in 94% and T-cell lymphoma in 6%. 96 lesions were identified (2.7 per patient). The mean size was 15.8 ± 8.3 mm. The number of intramammary lesions was higher in secondary than in primary lymphoma. The size of the identified intramammary lesions was larger in primary than in secondary lymphoma. Clinically, 86% of the patients presented with solitary or multiple breast lumps. In 14%, breast involvement was diagnosed incidentally during staging examinations. On mammography, intramammary masses were the most commonly seen (27 patients, 82%). Architectural distortion occurred in three patients (9%). In three patients (9%), no abnormalities were found on mammography. On ultrasound, the identified lesions were homogeneously hypoechoic or heterogeneously mixed hypo- to hyperechoic. On MRI, the morphology of the lesions was variable. After intravenous administration of contrast medium, a marked inhomogeneous contrast enhancement was seen in most cases. On CT, most lesions presented as circumscribed round or oval masses with moderate or high enhancement.