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We read with great interest the recently published article by Windrum et al about a mantle cell lymphoma presenting as a breast mass.1 A separate case of mantle cell lymphoma involving both breasts was also reported last year.2 We wish to report the third case of a mantle cell lymphoma involving the breast, in this case presenting as bilateral breast masses. The patient is a 77 year old woman whose bilateral masses were palpated on routine physical examination. Core biopsies were performed and the biopsied tissues were processed routinely in our laboratory. All microscopic patterns were identical bilaterally. The entirety of the specimen consisted of a diffuse monomorphic population of small lymphocytes. Adipose tissue or residual ductal units were not identified. The immunohistochemical profile of the tumour was evaluated on 4 μm thick, dewaxed sections using the standard streptavidin–biotin immunoperoxidase technique with diaminobenzidine as chromogen. The cells were strongly positive for CD5 (clone 54/F6; dilution, 1/80; Dako, Carpinteria, California, USA), cyclin D1 (clone AB-1; dilution, 1/100; Neomarkers, Fremont, California, USA), and bcl-2 (monoclonal; dilution, 1/40; Dako), but were negative for CD23 (clone MHM-6; dilution, 1/100; Dako). We interpreted this immunophenotypic profile as being most consistent with mantle cell lymphoma. Several types of lymphoma have been reported in the breast, with diffuse large B cell non-Hodgkin's lymphoma being the most common.3 These three cases show that mantle cell lymphoma should be included in that differential diagnosis.
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