Hodgkin's Lymphoma of the Breast

Abstract

A 49-year-old white woman presented with a 3-week history of right-breast redness and swelling after an insect bite. Physical examination revealed a 2 ϫ 1 cm nodule in the upper outer quadrant of the right breast, with diffuse tenderness, erythema, warmth, and peau d'orange (Fig 1 ) of the breast, and subcentimeter mobile painless adenopathy of the ipsilateral axilla. She was treated with oral cephalexin for a presumptive insect bite-related cellulitis. On follow-up physical examination 10 days later, there was no improvement in the breast findings, and there was a new nontender 1-cm supraclavicular lymph node on the right. A review of systems was significant for truncal and right-arm pruritis for 2 weeks and a 10-pound (Ͻ 5% body weight) weight loss over 1 month without pain, fevers, or night sweats. A CBC showed a WBC count of 11.1 K/mm 3 (normal range, 4.5 to 11 K/mm 3 ) with an absolute lymphopenia (1.54 K/mm 3 ), a hemoglobin of 11.7 g/dL (normal range, 12 to 16 g/dL), and a normal platelet count. The lactate dehydrogenase was mildly elevated at 257 U/L (normal range, 125 to 243 U/L), and albumin was 3.6 g/dL (normal range, 3.2 to 5 g/dL), with otherwise normal liver function.

Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment

“…Breast lymphoma can rarely present with extended lymphedema, stimulating inflammatory breast carcinoma. To the best of our knowledge, three cases of HL with breast inflammatory presentation have been reported so far [14, 15, 20]. Our case shows similarities with the previous reports regarding the clinical appearance.…”

Primary Hodgkin’s Lymphoma of the Breast Initially Treated by Surgical Excision and Axillary Dissection

“…Some recent studies have shown that primary non-Hodgkin's lymphoma of the breast involving the axilla usually presents with the clinical appearance of inflammatory breast carcinoma without infiltration of the breast dermal lymphatics 6 . Tumor growth is usually accelerated 7 , which leads to enlarged tumors like the one described by Rahmat et al 8 . EBV has been postulated to play an important role in the pathogenesis of Hodgkin's lymphoma.…”

Hodgkin′s lymphoma of the breast

“…[6] Our patient also presented with axillary (bilateral), supraclavicular, cervical, and submandibular lymphadenopathy as well as oedema of the chest wall and upper limbs, similar to the earlier reported cases (rare cases). [7] In a series of 84 patients with primary breast lymphoma, most of the patients had painless palpable breast mass, only 10 (11.9%) had pain in the breast; while another 10 (11.9%) had their diagnoses during routine mammography as they did not have any palpable breast mass. [4] An overwhelming majority of patients presenting with breast lymphoma are middle aged and elderly women with preponderance in the right breast, though bilateral disease has been reported.…”