Lymphoma - stage IV

Case contributed by Dr Amr Farouk

Presentation

Patient complaining of right breast and axillary masses.

Patient Data

Age: 25 years
Gender: Female

Marked asymmetrical enlargement of the right breast with multiple heterogeneous parenchymal masses and ipsilateral enlarged axillary lymph nodes. Enlarged right internal mammary lymph nodes are seen.

Severely enlarged spleen with no focal lesions within.

Multiple discrete and amalgamated pathologically enlarged para-aortic and retrocrural lymph nodes.

Bilateral ovarian heterogeneously enhancing masses.

Mild ascites.

Diffuse heterogeneous osseous texture with L1 and L3 anterior vertebral wedging and left iliac bone osteolytic lesions.

Case Discussion

Supra- and infra-diaphragmatic lymphadenopathy with right breast masses, splenomegaly, ovarian masses and osseous involvement.

CT picture suggestive of stage IV lymphoma (Cotswolds-modified Ann Arbor classification).

True cut biopsy from the right breast masses showed non-Hodgkin's lymphoma.

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