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[Clinical and Pathological Analysis of 9 Patients with Primary Breast Diffuse Large B-cell Lymphoma]
Zhong-Ling Wei1, Dong-Ping Huang1, Gui-Ping Su1
1Department of Hematology, Yijishan Hospital, Wuhu 241000, Anhui Province, China.
Insights
Primary breast diffuse large B-cell lymphoma (PBDLBCL) predominantly affects women and is often a non-germinal center B-cell type, frequently presenting as Double-Hit lymphoma. Treatment with R-CHOP chemotherapy offers the best outcomes.
Area of Science:
- Oncology
- Hematology
- Pathology
Context:
- Primary breast diffuse large B-cell lymphoma (PBDLBCL) is a rare extranodal non-Hodgkin lymphoma.
- Understanding its clinical presentation and treatment is crucial for patient outcomes.
Purpose:
- To investigate the clinical features, diagnostic methods, and treatment strategies for PBDLBCL.
- To evaluate the efficacy of different therapeutic approaches.
Summary:
- This retrospective study analyzed 9 PBDLBCL cases, predominantly affecting women (average age 48).
- The main pathological subtype was non-GCB with Double-Hit lymphoma. Tubular needle biopsy proved effective for diagnosis.
- R-CHOP chemotherapy, alone or combined with radiotherapy, yielded the best treatment outcomes, with 6/9 patients achieving complete response.
Impact:
- Highlights the importance of early diagnosis and appropriate treatment selection for PBDLBCL.
- Suggests intrathecal chemotherapy may help prevent central recurrence.
- Provides insights into the characteristics and management of this rare lymphoma subtype.
Objective:
To explore the clinical features, diagnosis and treatment of primary breast diffuse large B- cell lymphoma (PBDLBCL).
Methods:
Clinical records of 9 PBDLBCL patients treated in Department of Hematology of Yijishan Hospital Affiliated to Wannan Medical College from August 2001 to January 2014 were analyzed retrospectively.
Results:
All of the 9 patients were female, with an average age of 48 years (range 28 to 75), 8 cases had unilateral breast tumors and 1 case had bilateral. According to the Ann Arbor stage standard, 2 cases were of stage IE and 7 were IIE. None of them was concurrent with B symptoms; 6 cases had IPI (International prognostic Index) score 0 and 3 had score 1. 2 cases belonged to germinal center B cells type (GCB) and 7 belonged to non-GCB. Double-Hit lymphomas were presented in 3 cases. Out of 9 cases, 3 cases were diagnosed by using tubular needle biopsy, 5 cases were diagnosed by using resection of breast mass, and 1 case was diagnosed by using modified radical mastectomy. 1 case received radical mastectomy, 1 case received unilateral breast removal, 1 case gave up, 1 case received mass excision with chemotherapy and radiotherapy, 5 cases received mass excision with chemotherapy and 1 case received central prophylaxis. A complete response (CR) was observed in 6 cases after first-line chemotherapy. The median follow-up time was 18 months (range 0.1 to 150), 3 cases relapsed and 5 cases died.
Conclusion:
PBDLBCL mostly occurs in female. The main pathological type is non-GCB coupled with Double-Hit lymphoma. Tubular needle biopsy offers benifit in the diagnosis of PBL, R-CHOP or R-CHOP combined with chemotherapy/radiotherapy produce best outcome among all the treatments. Intrathecal injection of chemotherapy drugs may help to prevent recurrence of PBL central.
