Breast Involvement by Hematologic Malignancies: Ultrasound and Elastography Findings with Clinical Outcomes

Aslan, Hulya; Pourbagher, Ayşin

doi:10.4103/jcis.jcis_65_17

Cited by 9 publications

(15 citation statements)

References 23 publications

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“…The elastography findings of intramammary hematologic malignancy have rarely been reported on [38–42]. Aslan et al conducted a study in which they assessed the elasticity of intramammary hematologic malignancies in 9 patients; the study revealed that the elasticities of intramammary hematologic malignancy are variablesoft in 2 patients, intermediate in 5, and high in 2 [39]. Of the 9 hematologic malignancy cases, only 1 was myeloid sarcoma, which demonstrated intermediate elasticity (shear-wave velocity: 4.68 to 5.74 m/s, virtual touch imaging: diffuse dark, same size with B-mode ultrasonography) [39].…”

Section: Discussionmentioning

confidence: 99%

“…Of the 9 hematologic malignancy cases, only 1 was myeloid sarcoma, which demonstrated intermediate elasticity (shear-wave velocity: 4.68 to 5.74 m/s, virtual touch imaging: diffuse dark, same size with B-mode ultrasonography) [39]. The published cutoff shear-wave velocity value for malignancies ranges from 4.1 to 5.2 m/s [39]. Another report also described the elastography findings of myeloid sarcoma of the breast, in which the Tsukuba elasticity score, strain index, and elasticity ratio were 2, 2.3, and 0.71, respectively; these values indicated a benign nature [38].…”

Section: Discussionmentioning

confidence: 99%

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Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report

Kim

2019

Am J Case Rep

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Patient: Female, 24 Final Diagnosis: Myeloid sarcoma of the breast Symptoms: Breast lump Medication: — Clinical Procedure: Core needle biopsy Specialty: Radiology Objective: Rare disease Background: Myeloid sarcoma is a rarely observed extramedullary presentation of myeloid leukemia that seldom manifests in the breast. Myeloid sarcoma can occur before, concurrently with, or following acute myeloid leukemia presentation. Few reports have focused on the imaging findings in cases of myeloid sarcoma of the breast, and the existing findings are variable and nonspecific; the present case report aimed to bridge this gap. Case Report: A 24-year-old female presented with a palpable lump at the upper outer quadrant of her right breast. She had noticed the mass 2 days prior to presentation. She was first diagnosed with acute myelogenous leukemia 18 months before the lump presentation and had undergone haploidentical stem cell transplantation 6 months prior. At the time of the breast lump presentation, she was undergoing chemotherapy for relapsed acute myeloid leukemia. Ultrasonography of her right breast revealed a circumscribed, oval mass corresponding to the palpable lump. Ultrasonography-guided 14-gauge core needle biopsy was performed on the breast mass, leading to a pathological diagnosis of myeloid sarcoma. Conclusions: We reported a case of myeloid sarcoma involving the breast. On sonography, although the internal echotexture resembled that of breast hamartoma, the observed hard elasticity and high vascularity raised suspicions of malignancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report

Kim

2019

Am J Case Rep

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“…MRI may show non-mass enhancement, solitary or multiple enhancing masses 4. MRI may show T2 hyperintensity signal or ring enhancement due to underlying peripheral angiogenesis and central necrosis 5.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the diagnosis would be more challenging if breast leukaemia infiltration is the only presentation 4. In the setting of undetermined and non-specific breast imaging, breast core biopsy should always be performed.…”

Section: Discussionmentioning

confidence: 99%

Acute myeloid leukaemia presenting with bilateral breast masses

Cheng

Lam

2018

BMJ Case Reports

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A 46-year-old woman with a known history of acute myeloid leukaemia presented with bilateral breast masses with pain and itchiness. The breast masses were hard on palpation. Mammogram was unremarkable. Ultrasound showed multiple conglomerated masses of heterogeneous hyperechogenicity and hypoechogenicity throughout all quadrants of bilateral breasts. Pathology showed mononuclear cells, suggestive of breast leukaemic infiltration. She was treated with decitabine and platelet transfusion.

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“…The central nervous system and testes are frequent locations and sanctuary sites for extramedullary relapses. Involvement of the breast by leukemia is uncommon but may manifest as an oncological emergency requiring prompt management[2-4]. Acute myeloid leukemia constitutes the most common type of acute leukemia in adults, and is also the most common type infiltrating the breasts.…”

Section: Introductionmentioning

confidence: 99%

Breathing adapted radiation therapy for leukemia relapse in the breast: A case report

Sager¹,

Dincoglan²,

Demiral³

et al. 2019

WJCO

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BACKGROUNDInfiltration of the breast by leukemic cells is uncommon but may manifest as an oncological emergency requiring prompt management. Extramedullary relapse of T-cell acute lymphoblastic leukemia (T-ALL) within the breast is exceedingly rare and there is paucity of data in the literature regarding this entity. No consensus exists on management of isolated extramedullary breast relapses of T-ALL. Herein, we report a case of isolated extramedullary breast relapse of T-ALL treated with breathing adapted radiation therapy (BART) using the active breathing control (ABC) system.CASE SUMMARYThe patient was a 33-year-old female with diagnosis of T-ALL. She received intensive systemic chemotherapy that resulted in complete remission of her disease, and then underwent allogeneic hematopoietic stem cell transplantation. After a 15 mo period without symptoms and signs of progression, the patient presented with palpable masses in both breasts. She complained from severe pain and swelling of the breasts. Imaging workup showed bilateral breast lesions, and diagnosis of breast infiltration by leukemic cells was confirmed after immunohistopathological evaluation. The patient suffering from severe pain, discomfort, and swelling of both breasts due to leukemic infiltration was referred to the Radiation Oncology Department for symptomatic palliation. Whole breast irradiation was delivered to both breasts of the patient with BART using the ABC system. The patient had complete resolution of her symptoms after treatment with BART.CONCLUSIONBART with the ABC system resulted in complete resolution of the patient’s symptoms due to leukemic infiltration of both breasts with T-ALL. This contemporary treatment technique should be preferred for radiotherapeutic management of patients with leukemic infiltration of the breasts to achieve effective symptomatic palliation.

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Breast Involvement by Hematologic Malignancies: Ultrasound and Elastography Findings with Clinical Outcomes

Cited by 9 publications

References 23 publications

Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report

Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report

Acute myeloid leukaemia presenting with bilateral breast masses

Breathing adapted radiation therapy for leukemia relapse in the breast: A case report

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