The hypo-echoic enlarged lymph node in the left axilla has malignant features. The breast lesion however did not show typical features of a malignancy, but on the other hand could not be characterized as typically benign, so we classified it as BIRADS 4. Before performing a biopsy the MRI was performed. The enhancement pattern was suggestive for malignancy.
To our surprise the biopsy of the breast lesion and the lymph node both showed a diffuse large cell B cell non Hodgkin's lymphoma. Further examination of the patient revealed no other localizations of a Hodgkin's lymphoma.
Practically at the same time of this examination a case report was published by Zechmann et al in the European Journal of Ultrasound of another case of a B cell lymphoma of the breast.
For more examples of malignant breast lesions see category 5.2 Malignant breast lesions.
B-cell lymphoma of the female breast: comparison of mammography, ultrasound and dynamic MRI.
Zechmann CM, Buchheidt D, Hildenbrand R, Teubner J.
Ultraschall Med. 2010 Feb;31(1):71-3.