Atallah Chantal, Altinel Gulbeyaz, Fu Lili, Arseneau Jocelyne, Omeroglu Atilla
McGill University Health Center, Montreal, QC, Canada H3A 1A1.
Case Rep Pathol. 2014;2014:534034. doi: 10.1155/2014/534034. Epub 2014 Jul 9.
Axillary nodal metastasis from a nonmammary neoplasia is much rarer than diseases associated with a primary breast carcinoma. However, this has to be considered in the differential diagnosis of nodal disease in patients with a history of breast cancer. Here, we report the case of a 73-year-old female with a past medical history of breast cancer, presenting with an ipsilateral axillary metastatic carcinoma. The immunohistochemical profile of the metastatic lesion was consistent with a high grade serous carcinoma. After undergoing a total abdominal hysterectomy and salpingo-oophorectomy, thorough pathological examination revealed two microscopic foci of serous carcinoma in the right fallopian tube, not detectable by preoperative magnetic resonance imaging. In this context, the poorly differentiated appearance of the metastatic tumor and positive staining for estrogen receptor, might lead to a misdiagnosis of metastatic breast carcinoma. As the therapeutic implications differ, it is important for the pathologist to critically assess axillary lymph node metastases, even in patients with a past history of ipsilateral breast carcinoma and no other known primary tumors.
非乳腺肿瘤引起的腋窝淋巴结转移比原发性乳腺癌相关疾病少见得多。然而，对于有乳腺癌病史的患者，在鉴别诊断淋巴结疾病时必须考虑到这一点。在此，我们报告一例73岁女性，既往有乳腺癌病史，出现同侧腋窝转移性癌。转移灶的免疫组化特征与高级别浆液性癌一致。在接受全腹子宫切除术和输卵管卵巢切除术后，彻底的病理检查发现右侧输卵管有两个浆液性癌微小病灶，术前磁共振成像未检测到。在这种情况下，转移瘤的低分化外观和雌激素受体阳性染色可能导致转移性乳腺癌的误诊。由于治疗意义不同，即使是同侧乳腺癌病史且无其他已知原发性肿瘤的患者，病理学家严格评估腋窝淋巴结转移也很重要。
