title: Secondary breast lymphoma diagnosed by vacuum-assisted breast biopsy: a case report.
abstract: BACKGROUND
  Breast lymphoma, either as a manifestation of primary extranodal disease or as secondary involvement, is a rare malignancy, and its diagnosis, prognosis, and treatment have not been clearly defined. On the other hand, Vacuum-assisted breast biopsy (VABB) is a minimally invasive technique with ever-growing use for the diagnosis of mammographically detected, non-palpable breast lesions.
  
  
  METHODS
  A symptom-free, 56-year-old woman presented with a non-palpable BI-RADS 4B lesion without microcalcifications. She had a positive family history for breast cancer and a history of atypical ductal hyperplasia in the ipsilateral breast four years ago. She reported having been treated for non-Hodgkin lymphoma 12 years ago. With the suspicion of breast cancer, mammographically guided VABB with 11-gauge probe (on the stereotactic Fisher's table) was performed. VABB made the diagnosis of a non-Hodgkin, grade II, B-cell germinal-center lymphoma. VABB yielded enough tissue for immunohistochemistry/WHO classification.
  
  
  CONCLUSIONS
  This is the first case in the literature demonstrating the successful diagnosis of breast lymphoma by VABB, irrespectively of the level of clinical suspicion. It should be stressed that VABB was able to yield enough tissue for WHO classification. In general, lymphoma should never be omitted in the differential diagnosis, since no pathognomonic radiologic findings exist for its diagnosis.
authors.affiliation: Breast Unit, 1st Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens; 114, Vas Sofias Ave, Athens 116 27, Greece. gzografo@med.uoa.gr.
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Afroditi
authors.initials: A
authors.lastname: Nonni
authors.forename: Dimitra
authors.initials: D
authors.lastname: Koulocheri
authors.forename: Philip
authors.initials: P
authors.lastname: Domeyer
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dardamanis
authors.forename: Nikolaos V
authors.initials: NV
authors.lastname: Michalopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pararas
authors.forename: Antonia
authors.initials: A
authors.lastname: Gounaris
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos