Primary Follicular Lymphoma in a Male Breast: A Case Report
A 46-year-old man was diagnosed with liver cirrhosis secondary to chronic hepatitis B infection. Ten years later, a mass with 1.5 cm diameter was detected by abdominal computed tomography (CT) scan in Couinaud's segment 8 during a routine follow-up. Viral serologic tests were positive for serum hepatitis B surface antigen (HBsAg), envelope antigen (HBeAg), and antibody (HBeAb) and negative for hepatitis C virus antibody. The patient underwent segmentectomy of the liver. Histology of the resected specimen revealed 1.2 cm HCC with Edmondson grade II and peritumoral microvessel invasion (pT2). The postoperative course was uneventful.\nFive months later, the patient presented with a painless palpable mass in the right chest wall. The mass was movable and round shaped without fixation to the skin or muscle. On mammography, there was a round, homogenous, well-circumscribed mass (). Ultrasonography revealed an oval hypoechoic mass, measuring 1.6 cm in diameter, on the right chest wall without evidence of axillary involvement. Excisional biopsy was performed for histologic examination. Microscopic findings showed atypical lymphoid cells with a follicular growth pattern. Immunohistochemical staining was positive for antibodies against CD20, B cell lymphoma (Bcl)-2, and Bcl-6, and negative for CD3 (). Definite histology was diagnosed as grade 1 FL of the breast based on morphologic features and immunohistochemistry. Positron emission tomography-CT, abdominal CT, and chest CT were used to stage the disease, and there were no other suspected lesions. Aspirate and bone marrow biopsy was performed for initial staging procedure, and the results revealed normocellular marrow with no evidence of malignancy. The stage was IEA according to the Ann Arbor staging system [], and the prognostic index was low according to the Follicular Lymphoma International Prognostic Index (FL-IPI) []. The patient did not receive further adjuvant therapy, and he remains alive with complete remission at 40 months after surgery.