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.