title: Primary non-Hodgkin malignant lymphoma of the breast. An immunohistochemical study of seven patients and literature review of 152 patients with breast lymphoma in Japan.
abstract: BACKGROUND
  The breast is rarely a primary site for extranodal malignant lymphoma. Most reported primary non-Hodgkin malignant lymphomas of the breast (PBL) are of B-cell phenotype.
  
  
  METHODS
  Histologic and immunohistochemical analyses of seven patients with PBL and a statistical analysis of 152 patients with PBL reported in the Japanese literature were performed.
  
  
  RESULTS
  Malignant lymphoma could not be predicted preoperatively with clinical and radiologic findings; breast carcinoma, fibroadenoma, and phyllodes tumor were the preoperative diagnoses. All patients were women; they ranged in age from 31 to 80 years (mean, 57.6 years). The right breast was involved initially in five patients. In four, only the breast was involved (Stage I), whereas in three, the ipsilateral axillary lymph nodes (Stage II) were involved at diagnosis. According to the Working Formulation, all patients belonged to the intermediate grade and were classified as having diffuse large cell (five patients) or mixed (two patients) lymphoma. Immunophenotypic analysis revealed that all patients had B-cell lymphoma. No patients had lymphoepithelial lesions, which is the characteristic feature in categorizing a lymphoma as a mucosa-associated lymphoid tissue (MALT) lymphoma. A statistical analysis of the patient reported in the Japanese literature has divided PBL into two types: a bilateral type that affects younger women and a unilateral type that has a broad age distribution, but preponderantly occurs in older women. The age and stage at diagnosis were significant prognostic factors in predicting the survival time, but the location and size of the tumor at initial presentation, histopathologic type, terminal leukemic manifestation, and treatment modality were not.
  
  
  CONCLUSIONS
  This study indicates that most PBL are diffuse large cell lymphoma of B-cell phenotype and that the age and stage at diagnosis are significant prognostic factors.
authors.affiliation: Second Department of Pathology, Okayama University Medical School, Japan.
authors.forename: H J
authors.initials: HJ
authors.lastname: Jeon
authors.forename: T
authors.initials: T
authors.lastname: Akagi
authors.forename: Y
authors.initials: Y
authors.lastname: Hoshida
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Yoshino
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: J
authors.initials: J
authors.lastname: Ito
authors.forename: T
authors.initials: T
authors.lastname: Kamei
authors.forename: K
authors.initials: K
authors.lastname: Kawabata
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007564:Japan; D008228:Lymphoma, Non-Hodgkin / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged
chemical_list: D015415:Biomarkers