Breast imaging findings in haematological malignancies

Objectives: The objectives of this article are to review and illustrate the imaging appearances of haematological malignancies in the breast.

Methods: With Institutional Review Board approval, a search of the surgical pathology records from 1st January 2000 to 1st July 2012 was performed for haematological malignancies.

Results: Forty-eight cases of haematological malignancies (42 women and 6 men) were identified with imaging available for review: 39 cases of breast lymphoma, 6 cases of chronic lymphocytic leukaemia, 2 cases of acute leukaemia and 1 case of known multiple myeloma.

Conclusions: Breast manifestations of haematological malignancies are rare. They can have a variable appearance at imaging and can mimic primary breast carcinoma. In the setting of suspicious breast imaging findings, pathological diagnosis of haematological malignancy is concordant. Correlation with a clinical history of prior haematological malignancy can be helpful in suggesting the diagnosis and help prevent unnecessary surgical treatment.

Teaching Points: • Breast haematological malignancies are rare but the imaging appearances can mimic breast carcinoma.

• Breast lymphoma, most often B-cell non-Hodgkin lymphoma, may be primary or due to secondary disease.

• At ultrasound, haematological malignancies may present as a heterogeneous or predominantly echogenic mass.

• Haematological malignancies show intense activity on PET/CT except myeloma which has low FDG uptake.