A rare case of non-invasive ductal carcinoma of the breast coexisting with follicular lymphoma: A case report with a review of the literature

Abstract

The double presentation of breast cancer and follicular lymphoma is extremely rare, and only six cases have previously been reported in the literature. In the present study, a case of synchronous ductal carcinoma in situ (DCIS) of the breast and follicular lymphoma is reported. During an annual breast screening procedure, a 49-year-old female presented with a hard induration under the nipple of the right breast and swelling of a soft lymph node (LN) in the right axilla. Mammography and ultrasonography revealed two lesions in the right breast: One was a tumor with microcalcification, 1.0 cm in diameter, and the other was a large, crude calcification, 2.5 cm in diameter. In addition, computed tomography and positron emission tomography revealed swellings of the bilateral axillary (Ax) LN and intra-abdominal para-aortic LN. The patient underwent excisions of the large calcified mass, a micro-calcified tumor and the right AxLN. The pathological and immunohistochemical studies revealed fat necrosis and DCIS of the breast, which was positive for the estrogen receptor and the progesterone receptor, while human epidermal growth factor receptor II protein expression was evaluated as 2+ and stage was classified as pTis pN0 M0, stage 0. Furthermore, the Ax node was diagnosed as follicular lymphoma, which was positive for cluster of differentiation (CD)20, CD79a, CD10 and B-cell lymphoma (Bcl)-2 protein, but negative for Bcl-6 protein. The clinical stage was classified as stage III. The patient was administered chemotherapy followed by radiotherapy to the conserved breast. Two years have passed since the surgery, and the patient is disease-free.

Risk of lymphoma subtypes by occupational exposure in Southern Italy

“…The observed association in this study between DLBCL subtype and agricultural occupations [OR = 10.9 (2.3–51.6)] is consistent with the results of a large pooled analysis of international studies [ 20 , 26 ]. Moreover, general farm workers were at high risk of developing MM [OR = 16.5 (1.4–195.7)], as reported by Morton et al [ 28 ].…”

“…We also analysed the crude risks for 4 tumour familiarity that did not show any statistical significance; a higher OR was observed only for breast cancer familiarity [OR = 2.15 (0.77–5.99)]. As reported in several experiences [ 23 – 26 ], smoking (pack/years) was not a significant risk factor for lymphomas.…”

Multifocal Bilateral Breast Cancer and Breast Follicular Lymphoma: A Simple Coincidence?

“…Moreover, neoplastic lymphoid cells could reduce tissue necrosis factor or interleukin-induced adhesion of breast cancer cells to the endothelial layer of the axillary lymph nodes, thus facilitating lymphatic dissemination to certain lymph nodes [ 5 ]. However, since some lymphomas develop outside of the nodal sinuses, these theories are not universally accepted, and any interaction between breast cancer and breast lymphoma may be overestimated [ 8 ].…”

“…Laudenschlager et al [ 1 ] describe a case of T3N0M0 IDC coexisting with follicular lymphoma in the ipsilateral lymph nodes. Finally, Tamaoki et al [ 8 ] described DCIS of the breast coexisting with lymphoma in the para-aortic lymph nodes. In all of these reports, lymphoma was discovered incidentally during the histologic examination of the specimen; however, in our case, a palpable inguinal lymph node was present.…”

A rare case of bilateral breast lobular carcinoma coexisting with primary breast follicular lymphoma

“…Breast cancer is the most common cancer after radiotherapy for early-stage Hodgkin lymphoma [6][7][8]. However, synchronous and metachronous breast cancer and follicular lymphoma is a rare condition, and the other reported cases are related to ductal breast cancer [9][10][11][12][13]. We report the first case of a synchronous incidence of follicular lymphoma with invasive lobar carcinoma of the breast.…”