Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature

Hairy cell leukemia/lymphoma (HCL) is a rare B-cell neoplasm primarily involving spleen, bone marrow, and blood. However, other sites of primary involvement do occur and can present a diagnostic and therapeutic challenge. We present an unusual case of HCL involving predominantly the breast that was...

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Main Authors: Monika Pilichowska, Ahmad Shariftabrizi, Ian Mukand-Cerro, Kenneth Miller
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2014/497027
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spelling doaj-05a2929f8bcf4d9b98b6a9bde6257f632020-11-24T20:59:47ZengHindawi LimitedCase Reports in Pathology2090-67812090-679X2014-01-01201410.1155/2014/497027497027Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the LiteratureMonika Pilichowska0Ahmad Shariftabrizi1Ian Mukand-Cerro2Kenneth Miller3Department of Pathology and Laboratory Medicine and Department of Hematology-Oncology, Tufts Medical Center, Tufts University Medical School, Washington Street 800, Boston, MA 02111, USADepartment of Pathology and Laboratory Medicine and Department of Hematology-Oncology, Tufts Medical Center, Tufts University Medical School, Washington Street 800, Boston, MA 02111, USADepartment of Pathology and Laboratory Medicine and Department of Hematology-Oncology, Tufts Medical Center, Tufts University Medical School, Washington Street 800, Boston, MA 02111, USADepartment of Pathology and Laboratory Medicine and Department of Hematology-Oncology, Tufts Medical Center, Tufts University Medical School, Washington Street 800, Boston, MA 02111, USAHairy cell leukemia/lymphoma (HCL) is a rare B-cell neoplasm primarily involving spleen, bone marrow, and blood. However, other sites of primary involvement do occur and can present a diagnostic and therapeutic challenge. We present an unusual case of HCL involving predominantly the breast that was diagnosed as an incidental finding during an elective reduction mammoplasty in an otherwise healthy asymptomatic woman. Bone marrow performed for staging revealed limited involvement by HCL. Notably, there was no splenomegaly and/or involvement of other extramedullary sites. The peripheral blood revealed minimal involvement detected by flow cytometry. Extensive immunohistochemical studies supported by positive BRAF V600E mutational status confirmed the diagnosis of HCL. The patient remains asymptomatic without treatment one year following the diagnosis. This is the first case of a well-documented HCL presenting primarily in the breast in an asymptomatic patient. We review the literature on extramedullary, extrasplenic involvement by HCL and discuss the diagnostic challenges as well as the utility of immunohistochemistry and molecular studies in the diagnosis of atypical presentations of HCL.http://dx.doi.org/10.1155/2014/497027
collection DOAJ
language English
format Article
sources DOAJ
author Monika Pilichowska
Ahmad Shariftabrizi
Ian Mukand-Cerro
Kenneth Miller
spellingShingle Monika Pilichowska
Ahmad Shariftabrizi
Ian Mukand-Cerro
Kenneth Miller
Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
Case Reports in Pathology
author_facet Monika Pilichowska
Ahmad Shariftabrizi
Ian Mukand-Cerro
Kenneth Miller
author_sort Monika Pilichowska
title Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
title_short Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
title_full Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
title_fullStr Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
title_full_unstemmed Primary Hairy Cell Leukemia/Lymphoma of the Breast: A Case Report and Review of the Literature
title_sort primary hairy cell leukemia/lymphoma of the breast: a case report and review of the literature
publisher Hindawi Limited
series Case Reports in Pathology
issn 2090-6781
2090-679X
publishDate 2014-01-01
description Hairy cell leukemia/lymphoma (HCL) is a rare B-cell neoplasm primarily involving spleen, bone marrow, and blood. However, other sites of primary involvement do occur and can present a diagnostic and therapeutic challenge. We present an unusual case of HCL involving predominantly the breast that was diagnosed as an incidental finding during an elective reduction mammoplasty in an otherwise healthy asymptomatic woman. Bone marrow performed for staging revealed limited involvement by HCL. Notably, there was no splenomegaly and/or involvement of other extramedullary sites. The peripheral blood revealed minimal involvement detected by flow cytometry. Extensive immunohistochemical studies supported by positive BRAF V600E mutational status confirmed the diagnosis of HCL. The patient remains asymptomatic without treatment one year following the diagnosis. This is the first case of a well-documented HCL presenting primarily in the breast in an asymptomatic patient. We review the literature on extramedullary, extrasplenic involvement by HCL and discuss the diagnostic challenges as well as the utility of immunohistochemistry and molecular studies in the diagnosis of atypical presentations of HCL.
url http://dx.doi.org/10.1155/2014/497027
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