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Right Breast (right + breast)
Selected AbstractsMyxoid liposarcoma of the breast in a 25-year-old female as a diagnostic pitfall in fine needle aspiration cytology: Report of a rare caseDIAGNOSTIC CYTOPATHOLOGY, Issue 9 2008Ishita Pant M.D. Abstract Primary sarcomas of the breast are extremely rare comprising less than 1.0% of all malignant tumors of the breast. It is even rarer to be reported in a 25-year-old female. This can cause a diagnostic dilemma not only for the clinician but also for the cytopathologist. A 25-year-old woman presented with a well defined firm, mobile lump in her right breast. With fine needle aspiration cytology (FNAC) and ultrasonography a diagnosis of fibroadenoma was made. The patient underwent lumpectomy. Histopathologically it was diagnosed as myxoid liposarcoma. This case is reported to highlight the fact that, even though rare in young females but the possibility of a breast lump being a myxoid liposarcoma does exist. This report discusses a primary myxoid liposarcoma of female breast, considers cytologic differential diagnoses with review of the relevant literature. Diagn. Cytopathol. 2008;36:674,677. © 2008 Wiley-Liss, Inc. [source] Development of three different neoplasias in a patient in an 18-year period of timeEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2010P. HERAS md HERAS P., GEORGOPOULOU A.P., HATZOPOULOS A. & KRITIKOS K. (2010) European Journal of Cancer Care 19, 413,416 Development of three different neoplasias in a patient in an 18-year period of time This study presents a rare case of a patient who developed three different types of neoplasia in an 18-year period of time. The case presents a 31-year-old man with a history of treated Hodgkin's lymphoma in the neck region at the age of 13 years. The patient was admitted at the General Hospital of Nafplio for differential diagnosis of pain in the right subcostal region initiated 1 month before his admission and normochromic, normocytic anaemia. The laboratory examinations lead to the diagnosis of a sarcoma in the cardioesophageal junction. The patient was subjected to total gastrectomy. Nine months later he is admitted with a palpable firm lump in the nipple of the right breast, which suggested a malignant neoplasia. The patient was subjected to modified radical mastectomy. The appearance of three different types of neoplasia in three different organ systems in the same patient and the infrequency of the specific neoplasias individually and in combination present a special interest considering the patient's genetic background and the uniqueness of the case in the international literature. [source] Metastatic esophageal carcinoma masquerading as inflammatory breast carcinomaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2007Christy L. Nebesio MD A 50-year-old Caucasian woman with a history of esophageal adenocarcinoma presented with a 3-week history of right breast swelling and progressive erythema. Twenty-two months prior to presentation, she had been diagnosed with adenocarcinoma of the esophagus (T3,N1,M1a) and underwent neoadjuvant chemoradiotherapy followed by surgical resection. On physical examination, the right breast was red, swollen (40% larger than the contralateral breast), tender to palpation, and warm to the touch (Fig. 1). No mass was palpable. On the basis of the clinical findings, inflammatory breast carcinoma was suspected. A punch biopsy revealed a poorly differentiated adenocarcinoma with extensive involvement of dermal lymphatics (Fig. 2). The clinical and histologic differential diagnosis included inflammatory breast carcinoma vs. metastatic esophageal adenocarcinoma to the skin of the breast. Figure 1. The affected breast resembled inflammatory breast carcinoma with erythema and prominent edema. The edema resulted in partial inversion of the nipple Figure 2. Within the reticular dermis and dermal lymphatics, there was a poorly differentiated adenocarcinoma. Many of the tumor cells had a signet ring morphology (hematoxylin and eosin, ×200) To resolve this question, immunohistochemical stains for estrogen and progesterone receptors and CDX-2 (BioGenex, San Ramon, CA, USA) were performed. CDX-2 is an intestinal homeobox gene expressed in gastrointestinal epithelium and gastrointestinal tumors. The tumor nuclei were positive for CDX-2 but negative for both steroid receptors (Fig. 3), confirming the diagnosis of metastatic esophageal adenocarcinoma. Figure 3. The tumor cells had strong nuclear immunoreactivity for CDX-2 (CDX-2 immunohistochemical stain, ×400) [source] Breast lymphoma in Sjögren's syndrome complicated by acute monocular blindnessINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 2 2010Helmar F. SOLDEVILLA Abstract A 69-year-old hypertensive woman presented with eye and mouth dryness, bilateral parotid gland enlargement, associated with anasarca and proteinuria. Family history was notable for malignancies including breast, nasopharyngeal and colon cancers. Physical exam disclosed hypertension, bilaterally enlarged, firm, non-tender parotid glands, fine bibasilar crackles and bipedal edema. Anti Ro/Sjögren's syndrome antigen A antibody was positive, with negative tests for anti La/Sjögren's syndrome antigen B and anti-nuclear antibody (ANA). Chest radiographs showed basal infiltrates. Sjögren's syndrome associated with glomerulonephritis and interstitial lung disease was diagnosed, and she received pulse methylprednisololone followed by oral prednisone with dramatic improvement. Two months later, while on prednisone 5 mg/day, she returned to the clinic with an enlarging fixed non-tender right breast mass. She underwent modified radical mastectomy of the right breast, and pathologic report revealed diffuse, small cell, non-Hodgkin's lymphoma of the breast; axillary lymph nodes were negative for tumor. She opted for alternative therapy and did not return to the clinic until 7 months later when she developed sudden monocular blindness in the right eye with no other systemic manifestations. Magnetic resonance imaging (MRI) revealed swelling and enhancement of intracanalicular and pre-chiasmatic segments of the right optic nerve and right side of the optic chiasm. Considerations were Devic's disease versus metastases. She received pulse methylprednisolone therapy (1 g/day for 3 days) with partial recovery of vision. She is scheduled for lymphoma chemotherapy to include rituximab. [source] Anatomy of the lactating human breast redefined with ultrasound imagingJOURNAL OF ANATOMY, Issue 6 2005D. T. Ramsay Abstract The aim of this study was to use ultrasound imaging to re-investigate the anatomy of the lactating breast. The breasts of 21 fully lactating women (1,6 months post partum) were scanned using an ACUSON XP10 (5,10 MHz linear array probe). The number of main ducts was measured, ductal morphology was determined, and the distribution of glandular and adipose tissue was recorded. Milk ducts appeared as hypoechoic tubular structures with echogenic walls that often contained echoes. Ducts were easily compressed and did not display typical sinuses. All ducts branched within the areolar radius, the first branch occurring 8.0 ± 5.5 mm from the nipple. Duct diameter was 1.9 ± 0.6 mm, 2.0 ± 90.7 mm and the number of main ducts was 9.6 ± 2.9, 9.2 ± 2.9, for left and right breast, respectively. Milk ducts are superficial, easily compressible and echoes within the duct represent fat globules in breastmilk. The low number and size of the ducts, the rapid branching under the areola and the absence of sinuses suggest that ducts transport breastmilk, rather than store it. The distribution of adipose and glandular tissue showed wide variation between women but not between breasts within women. The proportion of glandular and fat tissue and the number and size of ducts were not related to milk production. This study highlights inconsistencies in anatomical literature that impact on breast physiology, breastfeeding management and ultrasound assessment. [source] Metastatic osteosarcoma to the breast: A rare caseJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2010Sabas Carlos Vieira Abstract Osteosarcoma is the most common malignant bone neoplasia and metastasizes mainly to the lung. Breast metastasis is an extremely rare event and poorly reported in the literature. We present a case of a 51-year-old patient, with a past surgical history of thigh osteosarcoma presented metastasis to the right breast and lung. She underwent the metastasis resection and later abandoned the treatment. Metastasis of osteosarcoma to the breast is an extremely rare event, but this diagnosis should be considered when meeting patients with a large breast nodule and a past history of osteosarcoma. [source] Zosteriform cutaneous metastases from breast adenocarcinomaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2005Konstantinos Bassioukas ABSTRACT Cutaneous metastases from breast adenocarcinoma are usually nodular, single or multiple. Their zosteriform distribution is very rare. We present a 54-year-old woman with cutaneous zosteriform nodular metastases on the right side of her thorax, and infiltration of the corresponding arm, 3 months after the excision of adenocarcinoma of her right breast. [source] Spontaneous regression of malignant lymphoma of the breastPATHOLOGY INTERNATIONAL, Issue 7 2004Kuniko Iihara A complete spontaneous regression of diffuse large B cell lymphoma involving the right breast, confirmed by aspiration cytology, is reported. The patient visited a hospital due to the rapid growth of a tumor in the right breast. Five years previously she underwent a craniotomy for a brain tumor, diagnosed as B-cell malignant lymphoma, and received several courses of irradiation to the brain. Analysis of the breast tumor cells obtained by aspiration revealed lymphoma cells morphologically, which were similar to the tumor cells in the brain expressing CD20. While waiting for further examination, the tumor regressed rapidly and was not palpable after 20 days. An excisional biopsy of the breast exhibited no definite malignant lymphoma cells among a diffuse population of CD45RO and CD8-positive small lymphocytes. Nucleotide sequencing of HCDR3s of the brain tumor and breast tumor cells showed a completely matched sequence, revealing the breast mass to be a metastatic lesion from the tumor of the brain. Although there was no tumorous lesion, the patient received additional chemotherapy and has shown no sign of recurrence in the breast for 7 years. We were able to confirm that the breast lymphoma shown in the aspiration cytology was a metastatic one, which was not proven histologically prior to chemotherapy, and regard the present case as a malignant lymphoma of the breast showing spontaneous regression. The present case shows a rare occurrence of spontaneous regression of diffuse large B cell malignant lymphoma after aspiration and suggests that CD8-positive T cells might be related to the regression. [source] Pro-Opiomelanocortin Expression in a Metastatic Breast Carcinoma with Ectopic ACTH SecretionTHE BREAST JOURNAL, Issue 4 2004Marie-Françoise Pelte MD Abstract: Cushing's syndrome secondary to ectopic adrenocorticotropic hormone (ACTH) secretion is rarely observed in breast carcinoma and only four cases have been previously published. We report here the case of a 50-year-old woman who presented with a history of diffuse bone pain associated with multiple hepatic, pulmonary, and bone metastases. A core needle biopsy specimen revealed an invasive ductal carcinoma in the right breast. The patient subsequently developed an ACTH-dependent paraneoplastic Cushing's syndrome and she died of arrhythmia and heart failure, despite treatment. At autopsy, immunohistochemical staining showed chromogranin A and ACTH positivity in the breast tumor and a lung metastasis. The mRNA expression of the pro-opiomelanocortin (POMC) gene was detected in tumoral cells by reverse transcriptase polymerase chain reaction (RT-PCR). This is the first case of Cushing's syndrome secondary to ectopic ACTH secretion where the presence of ACTH by immunohistochemistry and the expression of the POMC gene by RT-PCR have both been demonstrated in a breast carcinoma with metastases. The clinical history and the pathologic findings are presented with the methods and results of the molecular analysis. This case illustrates an example of ectopic ACTH syndrome in a breast carcinoma with neuroendocrine (NE) differentiation. This NE phenotype is directly related to the synthesis of ACTH by the tumoral cells. It should be kept in mind that an ectopic ACTH syndrome may be produced not only by small cell carcinoma or endocrine tumors but also by breast cancer. No relationship has been established between NE features and prognostic factors or patient outcome for this peculiar type of breast carcinoma. The demonstration of mRNA POMC in breast carcinoma with NE features suggests a depression and/or an activation of the POMC gene linked to the NE differentiation., [source] A 19 Year Old with Complete Androgen Insensitivity Syndrome and Juvenile Fibroadenoma of the BreastTHE BREAST JOURNAL, Issue 6 2001Steven E. Davis MD We report a case of a 19-year-old female with complete androgen insensitivity syndrome (CAIS) who was diagnosed with a juvenile fibdroadenoma of the breast. The patient presented at age 18 with primary amenorrhea. She had been raised as a female and went through thelarche at age 13 and adrenarche at age 14. She had two sisters and three maternal aunts with androgen insensitivity syndrome. Physical exam revealed that the patient had no cervix, and a pelvic sonogram confirmed that the uterus was absent. Genetic analysis revealed a 46 XY karyotype. Bilateral intra-abdominal testes were noted on ultrasound and subsequently removed. She was placed on synthetic estrogen replacement therapy. Roughly 1 year following orchiectomy, the patient noticed an enlarging mass in her right breast. Physical exam revealed a roughly 5 cm mobile mass in the upper portion of the nipple-areolar complex. Ultrasound showed a solid mass consistent with a fibroadenoma. Because of the size of the lesion and the patient's hormonal make-up, a fine needle aspirate was obtained. Cytopathology showed large cohesive sheets of ductal epithelial cells, scattered histiocytes, numerous bare nuclei, fragments of fibrous tissue and metachromatic stroma. Some of the stroma was noted to be cellular. The tumor was subsequently excised. Microscopically, the lesion had epithelial and stromal hyperplasia consistent with a fibroadenoma. Phyllodes-like qualities of large size, increased stromal cellularity, and intracanalicular growth ("leaf-like projections") were noted; however, the pathologist found that the florid epithelial hyperplasia and the patient's young age were more compatible with a juvenile fibroadenoma. We describe what we believe to be the first report of a patient with CAIS and a fibroadenoma of the breast. The hormonal imbalance typically found in these patients, combined with the fact that most individuals with CAIS receive exogenous estrogen therapy, suggests that there may be a relatively high incidence of fibroadenoma in these patients. 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