We have experienced a rare case of bilateral metachronous B cell lymphoma of the breast with terminal leukemic manifestation.
The patient, a 65 year-old female, was admitted to the Kyushu Cancer Center in 1973 because of a right breast tumor.
Under the histological diagnosis of medullary carcinoma with lymphoid infiltration (the diagnosis was reviced to malignant lymphoma by reobservation), super radical mastectomy was performed.
After seven years from the first operation, she noticed a left breast tumor. The tumor was diagnosed as non-Hodgkin's lymphoma of large cell type by following cytologic features in an imprint smear.
(1) Lymphoma cells were round in shape and 20 to 35 microns in diameter with May-Grunwald-Giemsa stain (10 to 15 microns with Papanicolaou stain).
(2) Some of nuclei were cleaved in shape, resembling lymphoblasts or centroblasts.
(3) PAS stain was negative but acid phosphatase reaction was diffusely positive with finely granular. The findings were consistent with those of B cell lymphoma.
Histologically the tumor was diagnosed as malignant lymphoma, diffuse, large cell type and B cell origin was confirmed by following immunological characters obtained from the leukemic tumors cells.
Immunological findings of lymphoma cells in periphelar blood were as follows:
(1) 91% positive for ERFC, (2) 85.9% positive for Ialike antigen (OKI 1), (3) 73.3% positve for anti-B1 antigen, (4) 33% positive for SmIg (κ-5%, λ-28%), (5) negative for C. Ig.
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