Authors: J. Navrátil 1; K. Petrakova 1; R. Nenutil 2; R. Vyzula 1; M. Svoboda 1 Authors‘ workplace: Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno2 Oddělení onkologické patologie, Masarykův onkologický ústav, Brno 1 Published in: Klin Onkol 2014; 27(2): 97-102 Category: Reviews
Case: Herein we report a case of a man with a B ‑ cell non‑Hodgkin lymfoma, primarily diagnosed by topographic and morfology tokens as lobular breast carcinoma and, as such, it was treated by chemotherapy and endocrine therapy. The treatment resulted in complete remission for 3,5 years. However, the subsequent relapses that arised in retrocrural and left axilary area did not respond adequately to breast cancer targeted chemotherapy. Therefore the patient underwent re‑exstirpation of axillary lymph node yielding a surprising histology finding of folicular lymphoma. The primary biopsy specimen was histologicaly re‑evaluated and the initial diagnosis was re‑classified as folicular lymphoma. The patient was given an adequate chemotherapy and targeted treatment that established a complete remission. Six months afterwards there was a relapse detected in the retrocrural area. The patient underwent palliative radiotherapy that brought about complete remission and, so far, he is in good condition. It has been eight years since the cancer diagnosis was established. This case report is appended by review of literature dealing with diagnostic confusion of these two malignancies.
Conclusion: Re ‑ biopsy plays a significant role in case of treatment strategy controversies, predominantly on condition of atypical course of malignant disease. It should always be considered in case of cancer relapse, especially if the phenotype specfication could affect the treatment decision.
Key words: breast cancer lobular – folicular lymphoma – diagnosis – histology – male
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