[Malignant lymphomas and other hematosarcomas with initial breast localization. Retrospective study of 20 cases]

A review of 20 cases of malignant lymphomas and other hematopoietic sarcomas initially localized in the mammary gland permitted us to determine some main clinical and morphologic features. Ages range from 14 to 74 years. Clinical features consist of two principal aspects: a radiologically homogeneous, well circumscribed mass or an inflammatory tumor. After staging, one half of the cases remain localized only in the mammary gland (extranodal stage I). Granulocytic sarcoma, monoblastic sarcoma and Hodgkin's disease are very rare. Non Hodgkin's lymphomas are the most frequent. In 40 per cent of the cases, it is a diffuse, large non cleaved cell type, according to the working formulation for clinical usage (centroblastic in the Kiel classification). These are probably B cell derived malignant lymphomas. Eleven per cent of the cases fall into the large cell with multilobated nuclei type according to Pinkus, which probably is a T cell derived malignant lymphoma. Treatment consists of radiotherapy and/or chemotherapy, mastectomy is not advisable. Like any malignant lymphoma localized in other sites, prognosis depends on two main data: clinical stage of the disease and histologic type. Ten patients are in complete remission, the median survival being 3.5 years.