Cancer Res Treat.  2014 Jan;46(1):104-107.

Primary Follicular Lymphoma in a Male Breast: A Case Report

• Jung SP
• Han KM
• Kim SJ
• Nam SJ
• Bae JW
• Lee JE

Abstract

Primary breast lymphoma (PBL) is a rare disease, particularly in males. Diffuse large B cell lymphoma is the most common PBL, while follicular lymphoma is less common. Furthermore, primary follicular lymphoma of a male breast is rarely reported. We report a male patient with primary follicular lymphoma of the breast and hepatocellular carcinoma (HCC). A 46-year-old man was diagnosed with liver cirrhosis secondary to chronic hepatitis B infection. Ten years later, he underwent segmentectomy of the liver due to HCC. Another 5 months later, he presented with a painless mass in the right chest wall. The mass was diagnosed as follicular lymphoma of the breast. The stage was IEA and he did not receive adjuvant therapy. Although only a few cases have been reported, lymphoma should be considered as a possible cause of breast mass, even in male patients.

Keyword

Breast; Follicular lymphoma; Hepatocellular carcinoma; Liver cirrhosis; Male

MeSH Terms

Breast*
Carcinoma, Hepatocellular
Hepatitis B, Chronic
Humans
Liver
Liver Cirrhosis
Lymphoma
Lymphoma, B-Cell
Lymphoma, Follicular*
Male*
Mastectomy, Segmental
Middle Aged
Rare Diseases
Thoracic Wall

Figure

• 

  Fig. 1 Mammographic images of a primary follicular lymphoma. Mammography shows a round, high-density mass

• 

  Fig. 2 Microscopic findings of a primary follicular lymphoma. (A) Note the proliferation of atypical lymphoid cells with a follicular growth pattern (H&E staining, ×40). The specimen is immunoreactive for CD20 (B; ×40) and Bcl-6 (C; ×12.5), and negative for CD3 (D; ×12.5).

Reference

1. Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer. 1972; 29:1705–1712. PMID: 4555557.

2. Jeanneret-Sozzi W, Taghian A, Epelbaum R, Poortmans P, Zwahlen D, Amsler B, et al. Primary breast lymphoma: patient profile, outcome and prognostic factors. A multicentre Rare Cancer Network study. BMC Cancer. 2008; 8:86. PMID: 18380889.

3. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971; 31:1860–1861. PMID: 5121694.

4. Solal-Celigny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R, et al. Follicular lymphoma international prognostic index. Blood. 2004; 104:1258–1265. PMID: 15126323.

5. d'Amore F, Christensen BE, Brincker H, Pedersen NT, Thorling K, Hastrup J, et al. Danish LYFO Study Group. Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Eur J Cancer. 1991; 27:1201–1208. PMID: 1835586.

6. Domchek SM, Hecht JL, Fleming MD, Pinkus GS, Canellos GP. Lymphomas of the breast: primary and secondary involvement. Cancer. 2002; 94:6–13. PMID: 11815954.

7. La Mantia E, Cantile M, Liguori G, Di Bonito M, De Chiara A, D'Aiuto M, et al. Breast systemic follicular lymphoma in a man: a case report. J Med Case Rep. 2012; 6:217. PMID: 22823980.

8. Martinelli G, Ryan G, Seymour JF, Nassi L, Steffanoni S, Alietti A, et al. Primary follicular and marginal-zone lymphoma of the breast: clinical features, prognostic factors and outcome: a study by the International Extranodal Lymphoma Study Group. Ann Oncol. 2009; 20:1993–1999. PMID: 19570964.

9. Berman K, Tandra S, Vuppalanchi R, Ghabril M, Sandrasegaran K, Nguyen J, et al. Hepatic and extrahepatic cancer in cirrhosis: a longitudinal cohort study. Am J Gastroenterol. 2011; 106:899–906. PMID: 21179013.

10. Marcucci F, Mele A. Hepatitis viruses and non-Hodgkin lymphoma: epidemiology, mechanisms of tumorigenesis, and therapeutic opportunities. Blood. 2011; 117:1792–1798. PMID: 20959600.

11. Engels EA, Cho ER, Jee SH. Hepatitis B virus infection and risk of non-Hodgkin lymphoma in South Korea: a cohort study. Lancet Oncol. 2010; 11:827–834. PMID: 20688564.

12. Horning SJ, Rosenberg SA. The natural history of initially untreated low-grade non-Hodgkin's lymphomas. N Engl J Med. 1984; 311:1471–1475. PMID: 6548796.

13. Lowry L, Ardeshna KM. Has single-agent rituximab replaced watch-and-wait for a patient with asymptomatic low-grade follicular lymphoma? Cancer J. 2012; 18:390–395. PMID: 23006942.

14. Solal-Celigny P, Bellei M, Marcheselli L, Pesce EA, Pileri S, McLaughlin P, et al. Watchful waiting in low-tumor burden follicular lymphoma in the rituximab era: results of an F2-study database. J Clin Oncol. 2012; 30:3848–3853. PMID: 23008294.