Korean J Radiol.  2013 Oct;14(5):718-722. 10.3348/kjr.2013.14.5.718.

Isolated Post-Transplantation Lymphoproliferative Disease Involving the Breast and Axilla as Peripheral T-cell Lymphoma

• Hwang JY
• Cha ES
• Lee JE
• Sung SH

• KMID: 1711424
• DOI: http://doi.org/10.3348/kjr.2013.14.5.718

Abstract

Post-transplantation lymphoproliferative disorders (PTLDs) are a heterogeneous group of diseases that represent serious complications following immunosuppressive therapy for solid organ or hematopoietic-cell recipients. In contrast to B-cell PTLD, T-cell PTLD is less frequent and is not usually associated with Epstein Barr Virus infection. Moreover, to our knowledge, isolated T-cell PTLD involving the breast is extremely rare and this condition has never been reported previously in the literature. Herein, we report a rare case of isolated T-cell PTLD of the breast that occurred after a patient had been treated for allogeneic peripheral blood stem cell transplantation due to acute myeloblastic leukemia.

Keyword

Breast; Breast neoplasm; Post-transplantation lymphoproliferative disease; Breast lymphoma; Breast US

MeSH Terms

Allografts
Axilla
Breast Neoplasms/diagnosis/*etiology/immunology
Diagnosis, Differential
Fatal Outcome
Female
Humans
Leukemia, Myeloid, Acute/surgery
Lymph Nodes/pathology
Lymphoma, T-Cell, Peripheral/*etiology/pathology/ultrasonography
Peripheral Blood Stem Cell Transplantation/*adverse effects
T-Lymphocytes/immunology/pathology
Transplantation, Homologous
Ultrasonography, Mammary/*methods
Young Adult

Figure

• 

  Fig. 1 Twenty two-year-old woman who had undergone allo-PBSCT presenting with vaguely palpable right breast mass. A-D. Ultrasound shows focal heterogeneous bulging parenchyma area, 2 suspicious irregular hypoechoic masses surrounding echogenic boundaries and right axillary lymph nodes that show nonspecific features with oval shape. E-F. Mammography shows 3, irregular, with ill-defined margin, iso- to slightly hyper-dense masses in right breast and several enlarged lymph nodes which are round to oval shape, some with loss of fatty hilum at right axilla. G. Histologic images of biopsied breast showed diffuse stromal infiltration of mononorphic lymphoid cells without organoid pattern. On high magnification, infiltrated lymphoid cells were small sized, and showed mild nuclear atypism (haematoxylin and eosin staining, × 400). H. Most lymphoid cells are positive for CD3 marker (immunohistochemistry staining, × 400), and negative for EBV (not shown). Overall findings are compatible with monomorphic post-transplant lymphoproliferative disorder, peripheral T cell lymphoma. I. FDG PET shows multiple increased uptake lesions in right breast and hot uptake in right axillary lymph nodes. However, other abnormal uptake is not noted.

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