Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report
Abstract Background Diffuse large B-cell lymphoma (DLBCL) with signet ring cell components is extremely rare. Here, we present a case of DLBCL with signet ring cell components involving the breast, which can be easily confused with invasive lobular carcinoma of the breast or metastatic signet ring c...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-023-02285-4 |
| _version_ | 1797859849557508096 |
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| author | Lu Zhang Qinqin Min Jiaxin Bi Xuewen Yu Yingying Liang Mumin Shao |
| author_facet | Lu Zhang Qinqin Min Jiaxin Bi Xuewen Yu Yingying Liang Mumin Shao |
| author_sort | Lu Zhang |
| collection | DOAJ |
| description | Abstract Background Diffuse large B-cell lymphoma (DLBCL) with signet ring cell components is extremely rare. Here, we present a case of DLBCL with signet ring cell components involving the breast, which can be easily confused with invasive lobular carcinoma of the breast or metastatic signet ring cell carcinoma of gastrointestinal origin. Case presentation A 66-year-old woman presented with a painless mass in her left breast. Enhanced magnetic resonance imaging (MRI) of the breast revealed a 42 × 29 × 28 mm mass in the left breast. Histological examination revealed a diffuse or scattered arrangement of round cells mixed with signet ring-like cells. Immunohistochemically, the neoplastic cells were positive for PAX-5, CD79a, CD20, Bcl-6, and MUM-1 but and negative for cytokeratin, ER, PR, E-cadherin, and P120. The Ki-67 proliferation index was approximately 70%. Fluorescence in situ hybridisation (FISH) demonstrated non-rearrangement of Bcl-2, Bcl-6, and c-MYC genes. Immunohistochemistry and FISH examination confirmed the diagnosis of DLBCL. Subsequently, immunofluorescence showed both IgM and IgG deposits in the signet ring-like lymphocytes. After confirming the diagnosis, the patient received four courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy in a specialist hospital and achieved partial remission; however, she unfortunately died of secondary pneumocystis pneumonia infection 3 months later. Conclusion Malignant lymphoma with signet ring cell morphology is quite uncommon, and this variant can be a diagnostic pitfall. We emphasise that pathologists should consider lymphoma in the differential diagnosis of malignant breast tumours. |
| first_indexed | 2024-04-09T21:37:17Z |
| format | Article |
| id | doaj.art-d5c5b585823e43f688063280b4e38ffa |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-04-09T21:37:17Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-d5c5b585823e43f688063280b4e38ffa2023-03-26T11:16:58ZengBMCBMC Women's Health1472-68742023-03-012311610.1186/s12905-023-02285-4Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case reportLu Zhang0Qinqin Min1Jiaxin Bi2Xuewen Yu3Yingying Liang4Mumin Shao5Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Pathology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese MedicineAbstract Background Diffuse large B-cell lymphoma (DLBCL) with signet ring cell components is extremely rare. Here, we present a case of DLBCL with signet ring cell components involving the breast, which can be easily confused with invasive lobular carcinoma of the breast or metastatic signet ring cell carcinoma of gastrointestinal origin. Case presentation A 66-year-old woman presented with a painless mass in her left breast. Enhanced magnetic resonance imaging (MRI) of the breast revealed a 42 × 29 × 28 mm mass in the left breast. Histological examination revealed a diffuse or scattered arrangement of round cells mixed with signet ring-like cells. Immunohistochemically, the neoplastic cells were positive for PAX-5, CD79a, CD20, Bcl-6, and MUM-1 but and negative for cytokeratin, ER, PR, E-cadherin, and P120. The Ki-67 proliferation index was approximately 70%. Fluorescence in situ hybridisation (FISH) demonstrated non-rearrangement of Bcl-2, Bcl-6, and c-MYC genes. Immunohistochemistry and FISH examination confirmed the diagnosis of DLBCL. Subsequently, immunofluorescence showed both IgM and IgG deposits in the signet ring-like lymphocytes. After confirming the diagnosis, the patient received four courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy in a specialist hospital and achieved partial remission; however, she unfortunately died of secondary pneumocystis pneumonia infection 3 months later. Conclusion Malignant lymphoma with signet ring cell morphology is quite uncommon, and this variant can be a diagnostic pitfall. We emphasise that pathologists should consider lymphoma in the differential diagnosis of malignant breast tumours.https://doi.org/10.1186/s12905-023-02285-4Diffuse large B-cell lymphomaSignet ring cellBreastFluorescence in situ hybridisationImmunofluorescenceCase report |
| spellingShingle | Lu Zhang Qinqin Min Jiaxin Bi Xuewen Yu Yingying Liang Mumin Shao Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report BMC Women's Health Diffuse large B-cell lymphoma Signet ring cell Breast Fluorescence in situ hybridisation Immunofluorescence Case report |
| title | Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report |
| title_full | Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report |
| title_fullStr | Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report |
| title_full_unstemmed | Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report |
| title_short | Signet ring cell-like diffuse large B-cell lymphoma involving the breast: a case report |
| title_sort | signet ring cell like diffuse large b cell lymphoma involving the breast a case report |
| topic | Diffuse large B-cell lymphoma Signet ring cell Breast Fluorescence in situ hybridisation Immunofluorescence Case report |
| url | https://doi.org/10.1186/s12905-023-02285-4 |
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