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Park JY, Yi SY. Case reports of shear-wave elastography (SWE) features of lymphoma involving the breast. Radiol Case Rep 2021; 17:641-646. [PMID: 35027988 PMCID: PMC8715132 DOI: 10.1016/j.radcr.2021.11.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/26/2022] Open
Abstract
Breast lymphoma is a rare malignancy that is often difficult to distinguish from other breast diseases. Elastography has been proven to facilitate the diagnosis of breast lesions. However, only few reports have focused on the elastographic features of breast lymphoma. Therefore, we herein present 2 cases of breast lymphomas with a focus on the elastographic findings.
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Affiliation(s)
- Ji Yeon Park
- Department of Radiology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Seong Yoon Yi
- Division of Hematology-Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, 10380, Republic of Korea
- Corresponding author.
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Gluskin J, D'Alessio D, Kim AC, Morris EA, Chiu A, Noy A. Primary lymphoma of the breast: A report of two cases. Clin Imaging 2020; 68:295-299. [PMID: 32961512 DOI: 10.1016/j.clinimag.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/06/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022]
Abstract
Primary breast lymphoma (PBL) should be distinguished from secondary breast lymphoma arising in the setting of lymphoma elsewhere in the body. Multimodality imaging is key to diagnosing PBL, and imaging manifestations thereof may indicate PBL and alter the treatment course. Treatment options including chemotherapy, radiation therapy, and/or surgery depend on histology. We report two cases of PBL, illustrating the transformative impact that multimodality imaging may have on clinical management.
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Affiliation(s)
- Jill Gluskin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Donna D'Alessio
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Andrew C Kim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - April Chiu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Ariela Noy
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
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Chen Y, Wang X, Li L, Li W, Xian J. Differential diagnosis of sinonasal extranodal NK/T cell lymphoma and diffuse large B cell lymphoma on MRI. Neuroradiology 2020; 62:1149-55. [PMID: 32562035 DOI: 10.1007/s00234-020-02471-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022]
Abstract
Purpose To evaluate whether imaging features on conventional magnetic resonance imaging (MRI) can differentiate sinonasal extranodal natural killer/T cell lymphomas (ENKTL) from diffuse large B cell lymphoma (DLBCL). Methods Consecutively, pathology-proven 59 patients with ENKTL and 27 patients with DLBCL in the sinonasal region were included in this study. Imaging features included tumor side, location, margin, pre-contrast T1 and T2 signal intensity and homogeneity, post-contrast enhancement degree and homogeneity, septal enhancement pattern, internal necrosis, mass effect, and adjacent involvements. These imaging features for each ENKTL or DLBCL on total 86 MRI scans were indicated independently by two experienced head and neck radiologists. The MRI-based performance in differential diagnosis of the two types of lymphomas was evaluated by multivariate logistic regression analysis. Results All ENKTLs were located in the nasal cavity, with ill-defined margin, heterogeneous signal intensity, internal necrosis, marked enhancement of solid component on MRI, whereas DLBCLs were more often located in the paranasal sinuses, with MR homogenous intensity, mild enhancement, septal enhancement pattern, and intracranial or orbital involvements (all P < 0.05). Using a combination of location, internal necrosis and septal enhancement pattern of the tumor in multivariate logistic regression analysis, sensitivity, specificity, and accuracy in differential diagnosis of ENKTL and DLBCL were 100%, 79.4%, and 91.9%, respectively, for radiologist 1, and were 98.3%, 81.5%, and 93.0%, respectively, for radiologist 2. Conclusion MRI can effectively differentiate ENKTL from DLBCL in the sinonasal region with a high diagnostic accuracy.
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Abstract
This retrospective study aimed to improve the diagnostic accuracy of breast lymphoma (BL) by analyzing the findings of BL on mammography and magnetic resonance imaging (MRI).Fifteen patients with breast lymphoma (BL, Primary/Secondary: 13/2) were confirmed by pathology. The imaging findings of those patients were analyzed by 2 senior radiologists.BL commonly showed significant enhancement with penetrating vessels and septation in masses on dynamic contrast-enhanced MRI (DCE-MRI). Diffusion limitation of BL is more pronounced than breast cancer on diffusion weighted imaging.The study suggests that the penetrating vessels and diffusion restriction of lesions are helpful for the diagnosis and differential diagnosis of BL.
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Affiliation(s)
- Changyu Zhou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Kun Lv
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dongya Lin
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yinxing Yu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yangyang Bu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
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Matsubayashi RN, Iwasaki H, Iwakuma N, Momosaki S. Methotrexate (MTX)-associated malignant lymphoma of the bilateral breast: imaging features in comparison to other nipple-areolar tumors. Clin Imaging 2019; 53:120-125. [DOI: 10.1016/j.clinimag.2018.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/06/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
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Aslan H, Pourbagher A. Breast Involvement by Hematologic Malignancies: Ultrasound and Elastography Findings with Clinical Outcomes. J Clin Imaging Sci 2017; 7:42. [PMID: 29296470 PMCID: PMC5747218 DOI: 10.4103/jcis.jcis_65_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/22/2017] [Indexed: 12/22/2022] Open
Abstract
Objective: Hematological malignancies very rarely involve the breast. The aim of this study is to retrospectively evaluate B-mode ultrasound (US) and elastography (ES) findings of breast involvement by hematologic malignancies with clinical outcomes. Materials and Methods: All core-needle biopsy results that were performed at our tertiary breast center from January 2013 to September 2016 were searched. Our search revealed 9 patients with breast involvement either by leukemia or lymphoma. All patients were examined using B-mode US and ES. US and ES findings were analyzed with the consensus of two radiologists, and clinical outcomes were noted. Results: The mean age of the study population was 41.6 years (range, 20–83 years). Two patients showed diffuse hypoechoic parenchymal infiltration. The elasticity assessments of these lesions were soft and intermediate. The remaining 7 patients had mass lesions. The elasticity assessment of these masses according to Breast Imaging Reporting and Data System US was as follows: Soft (n = 1), intermediate (n = 4), high (n = 2). Conclusions: It is important to consider that hematologic malignancies may appear as soft or intermediate lesions on ES. Patients’ history and clinical background should help us to consider breast involvement. In addition, the clinical outcomes may not be related with elasticity assessments.
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Affiliation(s)
- Hulya Aslan
- Department of Radiology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Dadaloglu Mh, Adana, Turkey
| | - Aysin Pourbagher
- Department of Radiology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Dadaloglu Mh, Adana, Turkey
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Wienbeck S, Meyer HJ, Uhlig J, Herzog A, Nemat S, Teifke A, Heindel W, Schäfer F, Kinner S, Surov A. Radiological imaging characteristics of intramammary hematological malignancies: results from a german multicenter study. Sci Rep 2017; 7:7435. [PMID: 28785116 PMCID: PMC5547097 DOI: 10.1038/s41598-017-07409-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/23/2017] [Indexed: 11/09/2022] Open
Abstract
To assess radiological procedures and imaging characteristics in patients with intramammary hematological malignancies (IHM). Radiological imaging studies of histopathological proven IHM cases from ten German University affiliated breast imaging centers from 1997-2012 were retrospectively evaluated. Imaging modalities included ultrasound (US), mammography and magnetic resonance imaging (MRI). Two radiologists blinded to the histopathological diagnoses independently assessed all imaging studies. Imaging studies of 101 patients with 204 intramammary lesions were included. Most patients were women (95%) with a median age of 64 years. IHM were classified as Non Hodgkin lymphoma (77.2%), plasmacytoma (11.9%), leukemia (9.9%), and Hodgkin lymphoma (1%). The mean lesion size was 15.8 ± 10.1 mm. Most IHM presented in mammography as lesions with comparable density to the surrounding tissue, and a round or irregular shape with indistinct margins. On US, most lesions were of irregular shape with complex echo pattern and indistinct margins. MRI shows lesions with irregular or spiculated margins and miscellaneous enhancement patterns. Using US or MRI, IHM were more frequently classified as BI-RADS 4 or 5 than using mammography (96.2% and 89.3% versus 75.3%). IHM can present with miscellaneous radiological patterns. Sensitivity for detection of IHM lesions was higher in US and MRI than in mammography.
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Affiliation(s)
- Susanne Wienbeck
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Hans Jonas Meyer
- University Hospital Halle, Department of Radiology, Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Johannes Uhlig
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Aimee Herzog
- University of Jena, Institute for Diagnostic and Interventional Radiology, Erlanger Allee 101, 07747, Jena, Germany
| | - Sogand Nemat
- University of Saarland, Institute for Diagnostic and Interventional Radiology, Kirrberger Str. 100, 66424, Homburg, Germany
| | - Andrea Teifke
- University of Mainz, Department of Diagnostic and Interventional Radiology, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Walter Heindel
- University of Muenster, Institute for Clinical Radiology, Albert-Schweitzer-Str. 33, 48149, Muenster, Germany
| | - Fritz Schäfer
- University of Kiel, Institute for Radiology and Neuroradiology, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Sonja Kinner
- University of Essen, Institute for Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, 45147, Essen, Germany
| | - Alexey Surov
- University Hospital Halle, Department of Radiology, Ernst-Grube-Str. 40, 06120, Halle, Germany.,University of Leipzig, Department of Diagnostic and Interventional Radiology, Liebigstr. 20, 04103, Leipzig, Germany
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Abstract
PURPOSE We aimed to evaluate the imaging features of breast lymphoma using magnetic resonance imaging (MRI). METHODS This retrospective study consisted of seven patients with pathologically confirmed breast lymphoma. The breast lymphomas were primary in six patients and secondary in one patient. All patients underwent preoperative dynamic contrast-enhanced MRI and one underwent additional diffusion-weighted imaging (DWI) with a b value of 600 s/mm2. Morphologic characteristics, enhancement features, and apparent diffusion coefficient (ADC) values were reviewed. RESULTS On MRI, three patients presented with a single mass, one with two masses, two with multiple masses, and one with a single mass and a contralateral focal enhancement. The MRI features of the eight biopsied masses in seven patients were analyzed. On MRI, the margins were irregular in six masses (75%) and spiculated in two (25%). Seven masses (87.5%) displayed homogeneous internal enhancement, while one (12.5%) showed rim enhancement. Seven masses (87.5%) showed a washout pattern and one (12.5%) showed a plateau pattern. The penetrating vessel sign was found in two masses (25%). One patient with two masses underwent DWI. Both masses showed hyperintense signal on DWI with ADC values of 0.867×10-3 mm2/s and 0.732×10-3 mm2/s, respectively. CONCLUSION Breast lymphoma commonly presents as a homogeneously enhancing mass with irregular margins and displays a washout curve pattern on dynamic MRI. A low ADC value may also indicate a possible diagnosis of breast lymphoma.
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Affiliation(s)
- Lijun Wang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kong EJ, Cho IH. F-18 FDG PET/MRI findings of primary breast lymphoma in two cases: FDG PET/MRI findings of primary breast lymphoma. Clin Imaging 2015; 39:682-4. [PMID: 25748090 DOI: 10.1016/j.clinimag.2015.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
We present the integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) findings of diffuse large B-cell lymphoma involving the breast in two women. They were admitted with palpable breast masses. PET/MRI revealed high (18)F-fluorodeoxyglucose (FDG) uptake in multinodular enhancing masses without other FDG-avid foci. Diffusion-weighted imaging showed restricted water diffusion and dynamic contrast MRI showed rapid increase and washout kinetics. High FDG accumulation in tumor is related to washout kinetics. We present the usefulness of integrated PET/MRI for lesion characterization and total body staging in breast lymphoma.
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Affiliation(s)
- Eun Jung Kong
- Department of Nuclear Medicine, Yeungnam University, College of Medicine, Daegu, Republic of Korea.
| | - Ihn Ho Cho
- Department of Nuclear Medicine, Yeungnam University, College of Medicine, Daegu, Republic of Korea
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