Diffuse B-cell lymphoma in the male breast: A rare case report

Abstract

Introduction: Lymphomas are a heterogeneous group of cancers derived from the immune system, characterized by
increased proliferation of lymph nodes or secondary lymphatic tissue. Breast involvement by lymphoma is uncommon,
representing only 0.1% of malignant breast lesions. Clinical similarities with breast cancer make preoperative diagnosis
of breast lymphoma difficult. Histologically, most primary breast lymphomas (PML) are of the B-cell type. The treatment
of PML is based on the recommendations for the treatment of lymphomas of other locations according to the histological type, staging, and characteristics of the patient. Case Report: A male, 83 years old, with no family history of breast
cancer, with Alzheimer’s disease. He presented at the mastology outpatient clinic referring to a tumor in the right breast,
with progressive growth. He reported having performed several treatments, including antibiotics, without improvement,
in a breast lesion. He denied fever, night sweats, and weight loss. On physical examination, he had multiple nodular, hardened, and erythematous lesions in almost the entire right breast, some with an ulceration area, located in the medial quadrants, measuring about 15×11 cm. Palpable axillary lymph nodes measuring 1.5 cm. A mammography showed a regular,
isodense nodule measuring 5.0 cm in the central region of the right breast — BI-RADS 4. He underwent a core biopsy,
with histopathology compatible with diffuse large B-cell lymphoma in the right breast and immunohistochemistry with
CD20 expression, MUM1, MYC, and 90% audience rating (Ki67). PET-CT showed a large cutaneous and subcutaneous
mass in the right breast measuring 15.8×4.8×9.2 cm, bilateral axillary lymphadenopathy and sparse areas of skin thickening. He was referred to the oncology service, which started chemotherapy using the R-MINI-CHOP protocol (Rituximab,
Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone). Currently, it has shown a good response to chemotherapy
treatment, with remission of the lesions.