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Primary breast lymphoma is a rare disease and representing 0.04 – 0.5% of all malignant female breast tumour. Patient usually present to palpable mass in the breast without any evidence of lymphoma in the other organs. Imaging finding is non-specific. Histopathologic exam is only confirmed with histopathologic examination. We report a 57 years old women presented with a palpable mass in the left breast from 2 month ago. Ultrasonography and elastography revealed a 3 cm hard lobulated mass. The mass was lobulated with partially obscured border in mammogram without micro calcification histopathologic and immunohistochemical finding confirmed the diagnosis. Chemotherapy was initiated with RCHOP regiment however after two cycle of chemotherapy there isn’t any obvious response to treatment .repeat biopsy revealed some edematous changes within tumoral mass resulted in false growth of tumor however after 8 cycle of chemotherapy the mass regressed. Early and accurate diagnosis and complete course of treatment is crucial for appropriate treatment strategies and avoid unnecessary mastectomy in management of primary breast lymphoma.