Primary Non-Hodgkin Lymphoma of the Breast Presenting as Infective Mastitis: A Rare Case Predominant lymphoma mimicking mastitis
Abstract
Background: Primer breast non-Hodgkin lymphoma is an extremely rare malignancy, accounting for only 0.1–0.5% of all breast cancers and 1.7–2.2% of extranodal lymphomas. Although it has traditionally been defined by the absence of systemic involvement at the time of diagnosis, this strict criterion has been increasingly challenged, as some patients initially present with breast lesions but also demonstrate concurrent systemic disease. In such cases, the term “breast-predominant lymphoma” has been proposed as a more accurate and clinically relevant descriptor. The disease typically manifests as a palpable mass and closely mimics breast carcinoma, making accurate differentiation essential for appropriate management.
Case Presentation: We present the case of a 52-year-old woman admitted to the intensive care unit (ICU) with sepsis and an infected breast mass. Laboratory findings revealed hypercalcemia and elevated inflammatory markers. Emergent hemodialysis, empirical antibiotics, and palliative mastectomy were performed. PET-CT imaging revealed both nodal and extensive extranodal disease. Histopathology confirmed high-grade B-cell lymphoma with BCL-2 and MYC rearrangements. No bone marrow involvement was detected. This case was evaluated as breast-predominant non-Hodgkin lymphoma.
Conclusion: This case highlights the importance of a multidisciplinary approach and the role of advanced diagnostics in the management of this rare disease.
Keywords: Lymphoma, high-grade, B-cell lymphoma, sepsis, breast neoplasms
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