PMC10493155_01
Summary of disease course and treatment situation.
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The patient's disease course and treatment history is summarized in Figure 1.
In the left breast, there was an extremely low echo nodule about 3.3*2.9*1.2cm in size, which was large lobulated, regular in shape, clear in boundary, and uneven in internal echo before therapy.
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Ultrasonography indicated the following: an extremely hypoechoic nodule with a size of 3.3x2.9 x 1.2cm was observed in the subcutaneous fat layer in the outer upper quadrant of the left breast, showing a large lobulated regular shape with a clear boundary, an uneven internal echo, an enhanced peripheral soft tissue echo, and no abnormal axillary lymph nodes (Figure 2).
HE staining showed diffuse, relatively uniform, medium sized cells with obvious atypia, considering to be diffuse large B-cell lymphoma. The ruler in indicates 20 mum.
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The pathology indicated a malignant tumor, and immunohistochemistry was recommended to exclude lymphoma (Figure 3).
PET/CT showed diffuse large B-cell lymphoma involving breast, spleen, and bone.
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PET/CT (Figure 4) showed soft tissue nodules in the upper quadrant of the left breast, abnormal high glucose metabolism in the corresponding parts on PET (SUVmax 9.9), multiple circular low density in the spleen (SUVmax 15.8), mass soft tissue density in the right posterior chest wall, and the cortex of the adjacent posterior ribs of the right 10th was blurred, seemingly discontinuous.
The ultrasound and PET/CT indicated complete remission of the DLBCL.
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The latest review was in March 2023 (Figure 5), when the breast ultrasound showed no obvious space occupation, PET/CT showed small flakes with slightly low density in the splenic parenchyma, the margin was not clear, and no obvious abnormal glucose hypermetabolism was observed on PET, which was considered to be the change after the lymphoma treatment, the disappearance of the breast and bone tumors.