PMC4264879_01
a Mammogram findings. The craniocaudal and mediolateral oblique (MLO) view revealed no mass lesion or other abnormality in the bilateral breasts. b Ultrasonography findings. An irregular, round and solid hypoechoic nodule in the 11:00 o'clock position corresponds to a nodule palpated on clinical examination
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Fig1
A heterogenic mass was seen on ultrasonography (Fig. 1b), but nothing was seen on a diagnostic mammogram (Fig. 1a).
Magnetic resonance imaging findings. A 3 x 2 x 2 cm mass in the upper right breast showed a malignant imaging pattern on dynamic study
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Fig2
Magnetic resonance imaging (MRI) revealed a 2.2-cm diameter mass in the right breast, showing a malignant imaging pattern in dynamic study, but no metastasis in the bilateral axillary lymph nodes (Fig. 2).
a Microscopic examination revealed neoplastic infiltrates composed of medium to large cells with round nuclei (HE, original magnification x400). b Immunohistochemical stain of CD3 revealed a strongly positive reaction within the tumor tissue (original magnification x400). c Immunohistochemical stain of CD20 revealed a negative reaction within the tumor tissue (original magnification x100)
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Fig3
Histologic analysis of the biopsy specimen was consistent with a peripheral T-cell lymphoma not otherwise specified and microscopic pathology revealed atypical lymphocytes containing medium to large round nucleoli and irregular nuclear shapes (Fig. 3a).
a Computed tomography showed a round mass, 4.8 x 2.6 x 5 cm, in the outer upper quadrant of the right breast with pleural effusions in both lungs before treatment. b The mass in the right breast and bilateral pleural effusions disappeared with nearly complete response after 6 cycles of CHOP chemotherapy
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Fig4
On re-evaluating her initial breast MRI, the CT scan had shown the breast mass progressing rapidly with a significant increase in tumor size and in the pleural effusions (Fig. 4a) before treatment.     CT scan showed a significant remission of the breast mass and pleural effusion in nearly complete response (Fig. 4b).