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Breast systemic follicular lymphoma in a man: a case report

Elvira La Mantia1, Monica Cantile1*, Giuseppina Liguori1, Maurizio Di Bonito1, Annarosaria De Chiara1, Massimiliano D'Aiuto2, Giuseppe Pannone3, Renato Franco1 and Gerardo Botti1

Author Affiliations

1 Pathology Unit, National Cancer Institute, Pascale Foundation, Naples, Italy

2 Department of Breast Surgery and Oncology, Division of Breast Surgery, National Cancer Institute, Pascale Foundation, Naples, Italy

3 Department of Surgical Sciences, University of Foggia, Foggia, Italy

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Journal of Medical Case Reports 2012, 6:217 doi:10.1186/1752-1947-6-217

Published: 23 July 2012

Abstract

Introduction

Breast involvement by non-Hodgkin lymphoma is particularly rare in men. We describe the case of a patient with a rapidly growing, painless gynecomastia-like nodule in the left breast. On ultrasonography, the nodule was suspicious for breast carcinoma.

Case presentation

A breast biopsy from a 54-year-old Caucasian man showed the morphoimmunophenotypical features of grade 3 follicular lymphoma. Moreover, fluorescence in situ hybridization analysis showed a t(14,18) translocation suggesting breast involvement by a systemic lymphoma rather than a primary breast lymphoma. The histological diagnosis was subsequently confirmed after nodule excision. Mediastinal and abdominal node involvement was then identified on computed tomography and positron emission tomography scans during staging examinations. Our patient was treated with chemotherapy. After three years our patient experienced a right retro-areolar relapse. He then received two further cycles of chemotherapy but developed a myeloid acute leukemia and, as a result of this, he subsequently died.

Conclusions

The rarity of breast lymphomas, especially in men, and the problems related to the therapeutic choices with these tumors require molecular techniques in association with classical histological diagnosis.

Keywords:
Follicular lymphoma; Male breast; t(14;18) translocation