Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
권호 표지
DOI QR코드

DOI QR Code

MR Spectroscopy and Diffusion Weighted Imaging Findings of Primary Non-Hodgkin Lymphoma of the Breast: Two Case Reports

유방에 발생한 일차성 비호지킨림프종의 자기공명 분광법 및 확산강조 영상: 2예

  • Nam, Sang Yu (Department of Radiology, Gil Hospital, Gachon University School of Medicine and Science) ;
  • Yoo, Eun Young (Department of Radiology, Gil Hospital, Gachon University School of Medicine and Science) ;
  • Choi, Hye-Young (Department of Radiology, Gil Hospital, Gachon University School of Medicine and Science)
  • 남상유 (가천의대 길병원 영상의학과) ;
  • 유은영 (가천의대 길병원 영상의학과) ;
  • 최혜영 (가천의대 길병원 영상의학과)
  • Received : 2014.04.11
  • Accepted : 2014.05.20
  • Published : 2014.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Primary non-Hodgkin lymphoma (NHL) of the breast is a very rare disease, and the mammographic and ultrasonographic findings of breast lymphoma are variable. There are several reports of magnetic resonance (MR) imaging findings in patients with breast lymphomas; however, few reports have described the findings observed on MR spectroscopy or the features of diffusion weighted (DW) imaging. The authors report the findings of classical MR imaging, MR spectroscopy and DW imaging of a 48-year-old woman and a 40-year-old woman with primary non-Hodgkin's lymphoma of breasts. Mammography and breast ultrasonography revealed a mass with circumscribed margin. The mass showed strong enhancement after contrast injection on MR imaging. DW imaging showed reduced diffusion and high-amplitude choline (Cho) peak at 3.22 ppm was detected by single voxel MR spectroscopy which was consistent with malignancy.

유방의 일차성 비호지킨림프종은 드문 종양으로 유방촬영술과 초음파에서 다양한 영상소견을 보인다. 하지만 자기공명영상소견은 여러개의 증례로만 보고되어 있고, 자기공명분광법과 확산강조영상에 대한 보고는 거의 없다. 저자들은 유방의 일차성 비호지킨림프종을 진단받은 두명의 여자환자의 증례를 기본 자기공명영상에 더하여 자기공명 분광법 및 확산강조 영상소견과 함께 보고하고자 한다. 종양은 유방촬영술과 초음파에서 경계가 좋은 종괴로 나타났으며, 조영증강자기공명영상에서 강한 조영증강을 보였다. 또한 다른 악성종양에서 나타나는 것과 같이 확산강조영상에서는 확산제한을 보이고, 자기공명분광법에서는 콜린값이 증가하는 소견을 보였다.

Keywords

References

  1. Abbondanzo SL, Seidman JD, Lefkowitz M, Tavassoli FA, Krishnan J. Primary diffuse large B-cell lymphoma of the breast. A clinicopathologic study of 31 cases. Pathol Res Pract 1996; 192:37-43 https://doi.org/10.1016/S0344-0338(96)80128-2
  2. Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer 1972;29:1705-1712 https://doi.org/10.1002/1097-0142(197206)29:6<1705::AID-CNCR2820290640>3.0.CO;2-I
  3. Ferguson DJ. Intraepithelial lymphocytes and macrophages in the normal breast. Virchows Arch A Pathol Anat Histopathol 1985;407:369-378 https://doi.org/10.1007/BF00709984
  4. Yang WT, Lane DL, Le-Petross HT, Abruzzo LV, Macapinlac HA. Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology 2007;245:692-702 https://doi.org/10.1148/radiol.2452061726
  5. Lyou CY, Yang SK, Choe DH, Lee BH, Kim KH. Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging 2007;31:234-238 https://doi.org/10.1016/j.clinimag.2007.02.028
  6. Surov A, Holzhausen HJ, Wienke A, et al. Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features. Br J Radiol 2012;85:e195-205 https://doi.org/10.1259/bjr/78413721
  7. Demirkazik FB. MR imaging features of breast lymphoma. Eur J Radiol 2002;42:62-64 https://doi.org/10.1016/S0720-048X(01)00416-8
  8. Mussurakis S, Carleton PJ, Turnbull LW. MR imaging of primary non-Hodgkin's breast lymphoma. A case report. Acta Radiol 1997;38:104-107
  9. Darnell A, Gallardo X, Sentis M, Castaner E, Fernandez E, Villajos M. Primary lymphoma of the breast: MR imaging features. A case report. Magn Reson Imaging 1999;17:479-482 https://doi.org/10.1016/S0730-725X(98)00178-7
  10. Yoshikawa MI, Ohsumi S, Sugata S, et al. Relation between cancer cellularity and apparent diffusion coefficient values using diffusion-weighted magnetic resonance imaging in breast cancer. Radiat Med 2008;26:222-226 https://doi.org/10.1007/s11604-007-0218-3
  11. Ei Khouli RH, Jacobs MA, Mezban SD, et al. Diffusionweighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging. Radiology 2010;256:64-73 https://doi.org/10.1148/radiol.10091367
  12. Matsubayashi RN, Inoue Y, Okamura S, Momosaki S, Nakazono T, Muranaka T. MR imaging of malignant primary breast lymphoma: including diffusion-weighted imaging, histologic features, and a literature review. Jpn J Radiol 2013;31:668-676 https://doi.org/10.1007/s11604-013-0232-6
  13. Mountford C, Ramadan S, Stanwell P, Malycha P. Proton MRS of the breast in the clinical setting. NMR Biomed 2009;22:54-64 https://doi.org/10.1002/nbm.1301
  14. Begley JK, Redpath TW, Bolan PJ, Gilbert FJ. In vivo proton magnetic resonance spectroscopy of breast cancer: a review of the literature. Breast Cancer Res 2012;14:207 https://doi.org/10.1186/bcr3132
  15. Bartella L, Morris EA, Dershaw DD, et al. Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study. Radiology 2006;239:686-692 https://doi.org/10.1148/radiol.2393051046
  16. Demirkan B, Balci P, Ozcan MA, et al. Primary non-hodgkin lymphoma of breast in a patient with rectal carcinoma and magnetic resonance spectroscopic examination. Breast 2005;14: 169-174 https://doi.org/10.1016/j.breast.2004.08.013