[Primary malignant lymphoma of the breast characterized by pleural, pericardiac, and central nervous system invasion and leukemic conversion].
A 46-year old married woman was admitted with a tumor in the left breast. Needle biopsy revealed non-Hodgkin's lymphoma. After preoperative irradiation, a standard curative mastectomy was performed. She had been in complete remission for 12 months, but she was readmitted because of dyspnea and pretibial edema. An echocardiogram and X-ray films of the chest revealed pericardial and bilateral pleural effusion. Cytological examination of both aspirated effusion showed many lymphoma cells compatible with the primary lesion. After the disappearance of effusion following 3 courses of VEPA-M regimen, left hemiparesis and left facial nerve palsy suddenly appeared. The number of the cells in the spinal fluid was 1496/microliters and most cells were lymphoma cells. A MRI scan of the brain showed high intensity lesions in the left thalamus and the white matter of the left temporal lobe on T2-weighted images. Two months after the onset of cerebral involvement, leukemic conversion occurred. Cell surface marker and immunoglobulin gene analyses indicated that these cells were of B cell origin. In spite of multidrug chemotherapy she died in 24 months after the onset of the disease.
Kanatani
Y
Y
Department of Blood Transfusion, National Defense Medical College.
Suzuki
H
H
Hatsuse
K
K
Nakamura
H
H
D001932:Brain Neoplasms / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006338:Heart Neoplasms / Q000473:pathology*; D006801:Humans; D007938:Leukemia / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010496:Pericardium / Q000473:pathology; D010997:Pleural Neoplasms / Q000473:pathology*