Ultrasound Diagnosis of Bilateral Primary Breast Burkitt Lymphoma in a 28-Year-Old Lactating Patient: A Case Report

Qiu-Xia Jiang,1 Li-Jing Shi,1 Xiu-Yang Hong,2 Yu-Qin Zhu,3 Qiu-Ling Guo,1 Wen Xie,1 Guo-Rong Lyu4 1Department of Ultrasound, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 2Department of Women Health Care, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 3Department of Pathology, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 4Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, People’s Republic of ChinaCorrespondence: Guo-Rong Lyu, Email [email protected]: Primary breast Burkitt lymphoma (PB-BL) is an exceedingly rare form of primary breast lymphoma. Ultrasonography is the preferred modality for diagnosing breast diseases; however, the ultrasonic features of Burkitt lymphoma have rarely been reported. Herein, we report a case of ultrasonically diagnosed bilateral PB-BL in a lactating patient and present a literature review. A 28-year-old female patient experienced bilateral breast engorgement starting more than a month after childbirth. At three months postpartum, the patient experienced extreme bilateral breast engorgement, with the skin appearing dark purple and jaundiced. Based on the imaging diagnosis, pathological, immunohistochemical, and molecular biological findings, she was diagnosed with Burkitt lymphoma involves bilateral breasts, right adrenal glands, uterus, and multiple bones. After 4 cycles of combination chemotherapy, the tumor basically disappeared, and then after autologous stem cell transplantation and one cycle of combination chemotherapy, the patient is generally in good condition and is under follow-up. We found that the ultrasonic characteristics of PB-BL are different from those of common breast cancer or lactation mastitis. PB-BL lesions are often multiple, large masses, and even involve the whole breast. The characteristic reticular structures are common in lesions, and irregular hyperechoic masses can be seen around it. The mass has abundant peripheral and internal blood flow signals, but internal calcification and attenuated posterior echoes of masses are rarely observed. Thus, the ultrasonic features of breast Burkitt lymphoma are somewhat specific and understanding these features is conducive to its early identification.Keywords: Burkitt lymphoma, ultrasonography, case report