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Extranodal lymphoma represents fewer than 0.5% of all breast malignancies. Secondary involvement of the breast with lymphoma is more common than primary breast lymphoma. The most common primary breast lymphoma is B-cell lymphoma. The initial imaging study of choice for a woman with a new breast mass is a diagnostic mammogram. In younger women ultrasound is more commonly the first imaging modality performed. Diagnosis is made from image-guided or physical examination-directed needle biopsy. Treatment is different from that for breast cancer, in that surgery is not the mainstay. Patients with breast lymphoma are treated primarily with chemotherapy and radiation.

IgG4-related disease is an uncommon sclerosing and inflammatory mass-forming disease that may affect a single organ or be systemic. The prototypical example of the disease is type 1 autoimmune pancreatitis. After the pancreatobiliary system, the head and neck is the next most common site for involvement by IgG4-related disease. Here, we describe the clinicopathologic features of the head and neck involvement by this disease process with particular attention to involvement of the major salivary glands, the lacrimal glands and periorbital tissues, the upper aerodigestive tract, the thyroid gland, lymph nodes, the ear, and the skin and soft tissues.

Poorly differentiated neuroendocrine tumors are uncommon tumors of the GI tract and often diagnosed without the identification of the primary site. Here, we describe a case of poorly differentiated neuroendocrine carcinoma of unknown primary that is diagnosed by bone marrow biopsy. A68-year-old male patient presented with worsening back pain, hypercalcemia, anemia, and altered mental status. Initially, imaging favored multiple myeloma. However, a bone marrow biopsy revealed morphologic and immunohistochemical features of neuroendocrine origin.