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Spontaneous Regression Of Primary Breast Lymphoma

Oya, M. 2009Breast cancer

Oya, M., Hirahashi, M., Ochi, M., Hashimoto, M., Ohshima, K., Kikuchi, M. and Tsuneyoshi, M. (2009), spontaneous regression of primary breast lymphoma. Pathology International, 59: 664-669. https://doi.org/10.1111/j.1440-1827.2009.02424.x

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Abstract

Described herein is a case of primary breast lymphoma (PBL) that underwent spontaneous regression (SR). A 71‐year‐old woman visited hospital because of the rapid growth of a tumor in her left breast. On imaging, including magnetic resonance imaging (MRI), a discrete solid nodule was detected, which suggested malignant tumor. Histology of the following core needle biopsy (CNB) specimen indicated diffuse large B‐cell lymphoma (DLBCL). The patient had no past history of lymphoma and there was no evidence of systemic lymph nodes enlargement. After CNB, however, the patient noticed that her breast nodule gradually decreased in size without any specific treatment. Subsequent MRI showed an ill‐defined nodular area suggesting a regressing tumor. Excisional biopsy indicated fibrotic mammary tissue devoid of large neoplastic lymphoid cells. The patient has remained well without evidence of recurrent lymphoma more than 18 months after her original diagnosis. This case is considered to be unique in a PBL showing SR, probably induced by an intervention of CNB and histologically confirmed on sequential examinations in addition to illustrative before‐and‐after imaging. To the best of the authors' knowledge no other PBL of DLBCL has been reported as undergoing a complete SR in the English‐language literature.

Case Details

Disease Location

Spontaneous regression of primary breast lymphoma

Personal Characteristics

71-year-old female

Clinical Characteristics

A painless mass a few centimeters in diameter in her left ac area (the mid-portion above the nipple) was noted. Echography, mammography and CT showed a definite nodule strongly suggesting a malignant lesion. Core needle biopsy (cnb) was performed and the histology was identical to that of dlbcl of activated b cell-like type.

Remission Characteristics

After cnb the patient noticed that her breast nodule was gradually decreasing in size without any specific treatment. Excisional biopsy specimen (4 weeks post initial cnb) showed fibrotic mammary tissue focally affected by small lymphocytic infiltrate; no definite neoplastic large lymphoid cells; (+) b cell markers, (+) t cell markers (+)CD8 (-) ebv

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible triggers for tumor withdrawal: performance of cnb as a small traumatic intervention, viral infection, presence of (+) CD8 cells

Clinical Treatment

Needle core biopsy