A penguin cap can be an effective method to avoid alopecia in patients receiving chemotherapy drugs. However, it is important to bear in mind that because of individual characteristics, liver function and drug regimens it is not successful in all cases.

Burkitt lymphoma (BL) is a highly aggressive neoplasm, which frequently affects the ileocecal region in the sporadic form and the jaw in the endemic form; however, the breast is a rare primary site of this tumor. Here we describe a case of primary bilateral breast BL presenting during lactation in a 23-year-old woman. Excisional biopsy of breast masses demonstrated a B-cell lymphoma with a characteristic 'starry sky' pattern highly suggestive of BL. The neoplastic cells strongly expressed CD20 and CD10, and showed proliferative activity as measured by Ki-67. An IGH-MYC gene fusion indicating the presence of a typical Burkitt translocation t(8;14)(q24;q32) in the tumor tissue was detected by fluorescent in situ hybridization. The present case, along with a comprehensive review of the literature, demonstrates that BL of the breast should be considered in the differential diagnosis of lesions of the breast during lactation. Whether hormonal or antigenic factors trigger Burkitt lymphomagenesis in the lactating breast warrants further investigation.

Anaplastic large T-cell lymphoma of the breast is rare, and can clinically mimic inflammatory breast carcinoma in adolescence.

A 65-year-old female presented to her oncologist after noticing an enlarging, solitary painless rightsided breast mass. Eight years previously, she had undergone right radical nephrectomy for a renal clear cell carcinoma. On examination, a soft retroareolar mass without skin or nipple changes was noted. Mammography revealed a solid smooth nodule in the mid portion of the right breast not seen on her previous mammograms 1 year prior ( Fig. 1). Ultrasound confirmed a 2.2-cm round, hypo-echoic nodule with welldefined margins and no shadowing (Fig. 2). Fine needle aspiration (FNA) biopsy and immunocytochemical study were performed.The aspiration was cellular mostly at the edges of the smears. The cells formed papillary, loose small clusters as well as isolated single cells (Fig. 3a,b). The individual cells were round to oval with moderate to abundant cytoplasm and essentially centrally or eccentric nuclei. The cytoplasm was foamy. The nuclei showed mild pleomorphism, but the nuclear ⁄ cytoplasmic ratio was not increased. Immunocytochemistry with monoclonal antibody to pancytokeratin (Novocastra, 5D3, prediluted, Novocastra, Newcastle, UK) and vimentin (Novocastra, V9, prediluted), which showed dual positivity and was against a breast primary. Cell block preparation showed aggregates of clear cells with clear cytoplasm and eccentric nuclei. Figure 1. Mammography revealed a solid smooth nodule in the mid portion of the right breast.Figure 2. Ultrasound confirmed a 2.2 cm round, hypo-echoic nodule with well-defined margins and no shadowing.