Breast lump (left side) visible on the skin, deep thickness on ultrasound, with extending toward back/underarm area. Breast lump excision performed, margins not clear per path report.
Initial path report: "dense lymphoid infiltrate composed of B and T cells that involve the skin and underlying superficial adipose tissue. Differential dx:reactive lymphoid hyperplasia and lymphoproliferative disorder. However, given the dense, deep nature of the infiltrate, we recommend re-biopsy." Biopsy sent on to another institution, report: Dx: "Atypical lymphoid infiltrate consistent with low-grade B Cell lymphoma of the extranodal marginal zone type with predominance of lambda-expressing plasma cells." - (oncologist recommended 5 weeks radiation after receiving this report). All set to do this...then another report comes in from another institution: "Mixture of CD20+ b cells and numerous CD3+/CD5+ T Cells, Bcl-2 is difficult to interpret ecause of large number of T cells. By outside report there is an increase in lambda+ plasma cells but these slides not available for our review". "Not sufficient evidence for dx of lymphoma, and suspect this lesion may represent a particularly florid cutaneous lymphoid hyperplasia." They also suggested nipple-related infections, but the lesion was back underneath the arm extending a bit onto the breast itself, no where near the nipple. This institution (3rd) received no clinical information, nor all the slides.
So, question is, what to do now? Oncologist is of the wait and watch idea...which now I'm nervous about.