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Metastatic "Ductal Carcinoma In Situ-Like" Lobular Carcinoma in a Lymph Node: A Case Report and Review of the Literature.
Int J Surg Pathol 2019; :1066896919888744IJ

Abstract

Metastatic breast cancer resembling ductal carcinoma in situ (DCIS) is a rare phenomenon. In this article, we present a unique case of metastatic lobular carcinoma with DCIS-like morphology in the left axillary lymph nodes of a 52-year-old female. She presented with 2 lesions in the left breast on mammography, and a mastectomy with axillary lymph node dissection was performed. Gross examination showed a 3.5 × 2.5 × 1.0 cm indistinct tumor in the lower outer quadrant and a 2.5 × 2.5 × 1.8 cm tumor in the upper outer quadrant. Microscopic assessment revealed a pleomorphic lobular carcinoma in the lower outer quadrant and a grade 2 invasive ductal carcinoma in the upper outer quadrant. Sixteen of the 17 axillary lymph nodes showed metastatic lobular carcinoma with foci of solid and comedo-type DCIS-like features. Immunohistochemical analysis of the primary and metastatic lobular carcinoma showed no expression of E-cadherin and p63 antibodies. To our knowledge, metastatic lobular carcinoma exhibiting this pattern has not been reported. The case suggests that lobular carcinoma can morphologically recreate a primary microenvironment at a distant site and simulate in situ growth. Recognition of this pattern is important to avoid misdiagnosis.

Authors+Show Affiliations

North Tyneside General Hospital, North Shields, UK.North Tyneside General Hospital, North Shields, UK.The Whittington Hospital, London, UK.Queens Elizabeth Hospital, Birmingham, UK. University of Birmingham, Birmingham, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31789065

Citation

Tijani, Sidiq, et al. "Metastatic "Ductal Carcinoma in Situ-Like" Lobular Carcinoma in a Lymph Node: a Case Report and Review of the Literature." International Journal of Surgical Pathology, 2019, p. 1066896919888744.
Tijani S, Sharma K, Yuen H, et al. Metastatic "Ductal Carcinoma In Situ-Like" Lobular Carcinoma in a Lymph Node: A Case Report and Review of the Literature. Int J Surg Pathol. 2019.
Tijani, S., Sharma, K., Yuen, H., & Shaaban, A. (2019). Metastatic "Ductal Carcinoma In Situ-Like" Lobular Carcinoma in a Lymph Node: A Case Report and Review of the Literature. International Journal of Surgical Pathology, p. 1066896919888744. doi:10.1177/1066896919888744.
Tijani S, et al. Metastatic "Ductal Carcinoma in Situ-Like" Lobular Carcinoma in a Lymph Node: a Case Report and Review of the Literature. Int J Surg Pathol. 2019 Dec 1;1066896919888744. PubMed PMID: 31789065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metastatic "Ductal Carcinoma In Situ-Like" Lobular Carcinoma in a Lymph Node: A Case Report and Review of the Literature. AU - Tijani,Sidiq, AU - Sharma,Kirti, AU - Yuen,Henry, AU - Shaaban,Abeer, Y1 - 2019/12/01/ PY - 2019/12/3/entrez PY - 2019/12/4/pubmed PY - 2019/12/4/medline KW - breast KW - ductal carcinoma in situ KW - lobular carcinoma KW - lymph node KW - metastatic DCIS-like features SP - 1066896919888744 EP - 1066896919888744 JF - International journal of surgical pathology JO - Int. J. Surg. Pathol. N2 - Metastatic breast cancer resembling ductal carcinoma in situ (DCIS) is a rare phenomenon. In this article, we present a unique case of metastatic lobular carcinoma with DCIS-like morphology in the left axillary lymph nodes of a 52-year-old female. She presented with 2 lesions in the left breast on mammography, and a mastectomy with axillary lymph node dissection was performed. Gross examination showed a 3.5 × 2.5 × 1.0 cm indistinct tumor in the lower outer quadrant and a 2.5 × 2.5 × 1.8 cm tumor in the upper outer quadrant. Microscopic assessment revealed a pleomorphic lobular carcinoma in the lower outer quadrant and a grade 2 invasive ductal carcinoma in the upper outer quadrant. Sixteen of the 17 axillary lymph nodes showed metastatic lobular carcinoma with foci of solid and comedo-type DCIS-like features. Immunohistochemical analysis of the primary and metastatic lobular carcinoma showed no expression of E-cadherin and p63 antibodies. To our knowledge, metastatic lobular carcinoma exhibiting this pattern has not been reported. The case suggests that lobular carcinoma can morphologically recreate a primary microenvironment at a distant site and simulate in situ growth. Recognition of this pattern is important to avoid misdiagnosis. SN - 1940-2465 UR - https://www.unboundmedicine.com/medline/citation/31789065/Metastatic_"Ductal_Carcinoma_In_Situ-Like"_Lobular_Carcinoma_in_a_Lymph_Node:_A_Case_Report_and_Review_of_the_Literature L2 - http://journals.sagepub.com/doi/full/10.1177/1066896919888744?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -