Possible role of anastrozole-induced hormonal alterations in pathogenesis of mammary apocrine carcinoma and follicular lymphoma: a case report and review of the literature

Our case suggests that unopposed local androgen exposure and loss of ERβ-mediated suppressive effect of estrogens may be involved in development of apocrine mammary tumors and lymphomas, respectively. However, further studies are necessary to clarify the roles of steroid hormones in pathogenesis of apocrine carcinoma and follicular lymphoma. This case also illustrates the importance of patient follow-up during and after aromatase inhibitor therapy. Appropriate surveillance for lymphoma may also be considered for those patients. Finally, when lymphoid aggregates are encountered in specimens from patients with breast cancer, a clinical history of hormonal therapy should alert the pathologist for a possibility of lymphoma.