BACKGROUND:

Breast hematologic malignancies are a rare condition, even more if they appear as the first manifestation of the disease and if they are T cells tumors.

OBJECTIVE:

The objective is to present a case report of an acute T-cell leukemia / lymphoma that started with breast bilateral palpable nodules, as well as to review its epidemiology, clinical characteristics, diagnosis and treatment.

CASE REPORT:

34-year-old woman, referred from primary care to the Breast Unit of our center after feeling two painless nodules in the right breast and one in the left breast for one month. The ultrasound study showed the presence in the left breast of a 12 mm rounded, isodense nodule with circumscribed outline. Another nodule with similar characteristics was observed in the contralateral breast along with bilateral lymphadenopathy. The histological, immunophenotypic and extension study diagnosed an Acute Cortical T-Thymic Leukemia / Lymphoid Lymphoma (T-III according to WHO 2016) with High Risk with systemic involvement of the disease and started chemotherapy induction treatment according to the PETHEMA LAL-AR/11 protocol. The patient presented a minimal negative residual disease from the start of the treatment without requiring an hematopoietic parents transplant despite being a high-risk case.

CONCLUSIONS:

Breast leukemic infiltration is a rare entity, even more if it constitutes the first manifestation of the disease. The presence of multiple bilateral breast nodules suspected as malignant in young patients, should include hematological malignancies in the differential diagnosis.

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