T-cell lymphoblastic lymphoma/leukemia involving bilateral breast: a case report

T-cell lymphoblastic lymphoma of the breast represents a highly uncommon subtype of non-Hodgkin's lymphoma. This study presents a case of T-cell lymphoblastic lymphoma/acute lymphoblastic leukemia (T-LBL/ALL) in a 73-year-old female patient exhibiting bilateral breast masses, bilateral axillary lymphadenopathy, swollen lymph nodes in the left neck, and petechiae on the chest. The breast ultrasound revealed heterogeneous hypoechoic findings in the skin layer and subcutaneous tissue of the upper outer quadrant of both breasts. Contrast-enhanced ultrasound demonstrated rapid homogeneous hyperenhancement of bilateral breast masses, and with a small unenhanced area noted in the center of the left breast mass. The fine-needle aspiration cytology of bilateral axillary lymph nodes revealed metastatic adenocarcinoma, whereas the fine-needle aspiration cytology of the left cervical lymph nodes indicated non-Hodgkin's lymphoma. Biopsy of the breast mass demonstrated multifocal growth of lymphocyte-like cells, with immunohistochemical analysis confirming T-LBL/ALL. This case study outlines the clinical and contrast-enhanced ultrasound features of breast T-LBL/ALL.