Téma: XXX. Kasuistiky
Číslo abstraktu: 267
An 81-year-old woman presented with a suspicious lesion in her right breast. After a clinical diagnosis of breast cancer, T2N1M0, stage II B, she underwent partial mastectomy with axillary lymph node dissection.
Pathologically the tumor tissue was composed of small to large lymphoid cells. Immunohistochemistry revealed that these cells were positive for CD20 and CD79a. The tumor cells inřltrated the ductular epithelial cells, distorting the duct structures, to form lymphoepithelial lesions, which were negative for CD10, CD23, Zyklin-D1, CD3, and CD5. Immunohistochemistry for cytokeratin and CD20 was helpful for identification. Infiltration rate of germinal centers were 60 - 70%. These cells were bcl2-bcl6+. MALT lymphoma with diagnosed. PET scan was negative at this time. The patient was treated with 5 cycles of fludarabine.
After 19 months she had a systemic relapse involving axillary lymphnodes and was PET – positive in the GI Tract. Colonoscopy was performed without histological positive result. The patient now was retreated with the combination of fludarabine, cyclophosphamid and mitoxantrone and is now in complete remission again.
MALT lymphoma or „extranodal marginal zone B-cell lymphoma tissue type“ is an extranodal lymphoma. 2,2% of extranodal lymphomas are located in the breast, representing 0,04% to 0,53% of all primary malignat tumors of the breast.
Datum přednesení příspěvku: 19. 4. 2008