title: Acute lymphoblastic leukemia presenting as a breast lump: A report of two cases.
abstract: Extra-medullary leukemic infiltration of the breast by acute lymphoblastic leukemia (ALL) is very rare. We report two cases of ALL presenting as breast masses and diagnosed on fine-needle aspiration (FNA). Our first patient, a post-partum 30-year-old female, developed bilateral breast lumps in her last trimester of pregnancy and complained of easy fatigability. Our second patient, a 14-year-old girl, presented with a right-breast lump of 1-week duration. She had received treatment for ALL 1 year back and had been in complete remission for the last 1 year. FNA of the breast nodules done in both the cases revealed diffuse infiltration by lymphoblasts. Subsequent hematological investigations confirmed bone marrow involvement by ALL in the first case and extra-medullary relapse in the second case. Fine-needle aspiration cytology (FNAC) is an easy and cost effective method for the early diagnosis of metastatic leukemic infiltration, avoiding unnecessary excisional biopsies in such cases.
authors.affiliation: Department of Pathology, Sher-e-Kashmir Institute of Medical Science, Soura, Srinagar, Jammu and Kashmir, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Besina
authors.forename: Zubaida
authors.initials: Z
authors.lastname: Rasool
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Samoon
authors.forename: Othman Salim
authors.initials: OS
authors.lastname: Akhtar
keywords: Acute lymphoblastic leukemia; breast; fine needle aspiration cytology