Abstract

Background: Primary breast lymphoma is a very rare disease. The diffuse large B cell subtype is the most common histological variety. The clinical presentation is non-specific; it can be similar to that found in breast carcinoma. The diagnosis is only retained after a definitive histological analysis. The management of these lymphomas is no different from that of other localizations. We report the case of primary breast diffuse large B cells lymphoma collected at the medical oncology department of the Hassan II Hospital of Fez in a 32-year-old patient. Through this work, we will discuss the epidemiological, clinical, paraclinical, histological, therapeutic, and prognostic characteristics of these tumors.

Case presentation: A 32-year-old woman consulted for a left breast nodule evolving for 3 months. Clinical examination objectified a painless mass of the left breast without inflammatory signs and homolateral axillary adenopathy of 3cm. Mammography and breast ultrasound were performed objectifying three tissue lesions measuring 26mm for the largest in the left breast, associated with homolateral axillary adenopathy. A micro biopsy was performed. Histological analysis showed breast parenchyma largely dissociated by cell proliferation of diffuse architecture with large cells. In immunohistochemistry, tumor cells were positive for the anti-CD20 antibody. An extension assessment with thoracoabdominal computed tomography did not show any secondary localization outside the breast lesions found in the mammography and ultrasound. Chemotherapy with R-CHOP was decided, but the patient refused to be treated for family reasons.

Conclusion: Through this work, a case of DLBCL was reported with a review of the literature. In summary, the DLBCL histological subtype is the most frequent form of mammary lymphoma. Consolidation radiotherapy after conventional chemotherapy remains the most reasonable therapeutic modality for the treatment of patients with DLBCL. Large studies are necessary to identify the factors that influence survival, to improve the management of patients with these lymphomas.

Keywords

breast, diffuse large B cell lymphoma, R-CHOP, systemic treatment, radiotherapy, therapeutic approach, breast diffuse, epidemiological, oncology department, paraclinical, prognostic characteristics, autopalpation, senological examination, lymphadenopathy