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Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report
Lu Zhang1, Qinqin Min1, Jiaxin Bi1
1Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
BMC Women'S Health
|March 23, 2023
Summary
Diffuse large B-cell lymphoma (DLBCL) with signet ring cells is a rare breast cancer. This case highlights the importance of considering lymphoma in breast tumor diagnosis to avoid misdiagnosis.
Area of Science:
- Oncology
- Pathology
Background:
- Diffuse large B-cell lymphoma (DLBCL) with signet ring cell morphology is an exceptionally rare entity.
- This specific presentation occurred in the breast, posing a diagnostic challenge due to potential confusion with invasive lobular carcinoma or metastatic gastrointestinal signet ring cell carcinoma.
Observation:
- A 66-year-old woman presented with a left breast mass.
- Histopathology revealed a mix of round and signet ring-like cells.
- Immunohistochemistry confirmed CD20, PAX-5, and MUM-1 positivity, with negative cytokeratin, ER, PR, and E-cadherin.
Findings:
- Immunohistochemistry and FISH confirmed DLBCL, with a high Ki-67 proliferation index (~70%).
- No rearrangement of Bcl-2, Bcl-6, or c-MYC genes was detected by FISH.
- Immunofluorescence showed IgM and IgG deposits in signet ring-like lymphocytes.
Implications:
- Malignant lymphoma with signet ring cell morphology is uncommon and can be a diagnostic pitfall.
- Pathologists must include lymphoma in the differential diagnosis for malignant breast tumors.
- This case underscores the need for thorough diagnostic evaluation in breast oncology.
