PRIMARY BREAST LYMPHOMA: AN IMMUNOMORPHOLOGIC STUDY OF A RARE ENTITY

Introduction& Objective: Breast lymphomas can be either arising primarily from the breast or as secondary involvement of the breast by primary nodal lymphomas. Primary breast lymphomas are extremely rare and account for 0.04 to 0.5% of all the breast malignancies and 1 to 2% of the extra nodal lymphomas. We studied the clinicopathologic features and subtypes of this rare disease at a regional cancer centre in South India. Methods: All cases of primary breast lymphomas diagnosed over a period of 11.5yrs, were included in the study. The demographic, morphologic and immunophenotypic features were analysed. Results: Thirteen cases of primary breast lymphomas were diagnosed and all were females. The mean age at presentation was 42.5yrs, with an age range of 19 to 65yrs. All the patients presented with unilateral breast lesion except one case with bilateral involvement. All 13 cases were Non-Hodgkin lymphomas(NHL), of which eleven cases were B-cell type and two cases were T-cell type (both anaplastic Large cell lymphomas- ALCL) and two cases were immunocompromised. The most common subtype of Bcell lymphoma was Diffuse Large B Cell Lymphoma (DLBCL). Discussion & Conclusion: DLBCL was the commonest primary breast lymphoma, most of them of the non germinal centre(NGCB) subtype. The two cases of ALCLs in our study were non- implant associated and Anaplastic Lymphoma Kinase(ALK- 1) positive. There was one case of plasmablastic lymphoma in a HIV infected individual. High index of suspicion and immunophenotyping play a vital role in the diagnosis of primary breast lymphomas and helps to make appropriate treatment decisions which in turn has prognostic implications.