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Related Experiment Videos

Malignant hematopoietic breast tumors

Y Lin1, R Govindan, J L Hess

  • 1Department of Pathology, Washington University Medical Center, St Louis, Missouri 63110, USA.

American Journal of Clinical Pathology
|February 1, 1997
PubMed
Summary

Hematopoietic neoplasms in the breast, including non-Hodgkin's lymphomas (NHLs), are often misdiagnosed as carcinoma due to similar microscopic features. Early identification is crucial to avoid unnecessary radical mastectomy and ensure proper treatment for these rare breast tumors.

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Area of Science:

  • Oncology
  • Hematology
  • Pathology

Background:

  • Hematopoietic neoplasms of the breast are rare but can be clinically and microscopically indistinguishable from breast carcinoma.
  • Accurate diagnosis is challenging, particularly in limited biopsy specimens, leading to potential misdiagnosis and inappropriate treatment.

Purpose of the Study:

  • To review and characterize hematopoietic breast neoplasms, focusing on histologic subtypes, morphologic features, and immunophenotype.
  • To highlight diagnostic challenges and potential pitfalls in differentiating these neoplasms from primary breast carcinomas.

Main Methods:

  • Retrospective review of 45 hematopoietic breast neoplasms, including primary and secondary non-Hodgkin's lymphomas (NHLs) and granulocytic sarcomas.
  • Histologic subtyping, morphologic assessment, and immunophenotyping were performed.

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Main Results:

  • Diffuse large cell type was the most common NHL subtype; mucosa-associated lymphoid tissue lymphomas were not identified.
  • Four primary NHLs, 2 secondary NHLs, and 1 granulocytic sarcoma were initially misdiagnosed as carcinomas, with some patients undergoing or nearly receiving radical mastectomy.
  • Specific morphologic patterns, such as "single file" or targetoid patterns with sclerosis and signet ring cells, mimicked invasive lobular carcinoma.

Conclusions:

  • Hematopoietic breast neoplasms continue to be misdiagnosed as carcinomas, underscoring the need for increased awareness among pathologists.
  • Histologic clues such as absence of in situ carcinoma, individual karyorrhectic cells, lymphoepithelial lesions, and cellular discohesiveness can suggest lymphomatous involvement.