Epithelium Involving Bilateral Axillary Lymph Nodes: Metastasis, Misplaced, or Mullerian!

2020 ◽  
pp. 106689692095812
Author(s):  
Kamaljeet Singh ◽  
Ruhani Sardana ◽  
M. Ruhul Quddus ◽  
Malini Harigopal
Keyword(s):  
Lymph Nodes ◽  
Frozen Section ◽  
Cancer Staging ◽  
Histological Evaluation ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Staging ◽  
Frozen Section Examination ◽  
First Case

During breast cancer staging, histological evaluation of axillary sentinel lymph nodes (SLN) is usually straightforward. However, the exact characterization of a small epithelial deposit in an SLN can be challenging, especially during the frozen section examination. We report the first case of endosalpingiosis involving bilateral axillary lymph nodes. We review published literature on axillary endosalpingiosis and discuss the differential diagnosis of small epithelial deposits in an axillary SLN. Pathologists should consider benign epithelial rests and displaced epithelium as differential diagnoses for the microscopic epithelial nodal deposit, especially during the frozen section examination.

scholarly journals Endosalpingiosis Is Negative for GATA3

2021 ◽  
Author(s):  
Marissa J. White ◽  
Russell Vang ◽  
Pedram Argani ◽  
Ashley Cimino-Mathews
Keyword(s):  
Soft Tissue ◽  
Lymph Nodes ◽  
Mammary Carcinoma ◽  
Cancer Staging ◽  
Positive Control ◽  
Axillary Lymph Nodes ◽  
Secretory Cells ◽  
Low Grade ◽  
Axillary Lymph ◽  
Breast Cancer Staging

Context.— Endosalpingiosis is a benign Müllerian inclusion that can mimic metastatic low-grade mammary carcinoma, particularly when encountered in axillary lymph nodes excised for breast cancer staging. Immunohistochemistry can be useful in histologically ambiguous cases, and a targeted immunopanel should include a marker of gynecologic tract origin and a marker of mammary origin. GATA3 is a sensitive immunomarker for breast carcinoma, but the immunoreactivity of GATA3 in endosalpingiosis has not been systematically evaluated. Objective.— To evaluate whether GATA3 immunohistochemistry could be used to differentiate endosalpingiosis from metastatic mammary carcinoma. Design.— Whole slide sections of 15 cases of endosalpingiosis involving nonneoplastic tissues were subjected to GATA3 immunohistochemistry. Nuclear GATA3 labeling was scored as percentage and intensity labeling, with any labeling considered positive; GATA3 labeling was recorded in all cells present in the sections. Results.— Half (47%, n = 7 of 15) of the endosalpingiosis cases involved lymph nodes (2 axillary, 5 pelvic) and half (53%, n = 8 of 15) involved pelvic organs or soft tissue (3 myometrial, 2 paratubal, 2 periadnexal soft tissue, and 1 pelvic sidewall). GATA3 immunohistochemistry was negative in all cases of endosalpingiosis, with intact, positive control labeling in lymphocytes. The benign fallopian tube epithelium present on the sections of paratubal endosalpingiosis displayed focal (<5%), weak labeling for GATA3, specifically within the ciliated and secretory cells. Conclusions.— These findings support the diagnostic utility of GATA3 immunohistochemistry and its use in a targeted immunopanel to resolve the differential diagnosis of metastatic low-grade mammary carcinoma (GATA3+) and nodal endosalpingiosis (GATA3−).

scholarly journals Unusual Occurrence of Rare Lipid-Rich Carcinoma and Conventional Invasive Ductal Carcinoma in the One Breast: Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Katarina Machalekova ◽  
Karol Kajo ◽  
Marian Bencat
Keyword(s):  
Lymph Nodes ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Frozen Section ◽  
Histological Grade ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Positive Staining ◽  
Axillary Lymph ◽  
Palpable Mass

A 56-year-old woman noticed a palpable mass in her left breast during self-examination. Patient was admitted to our hospital and malignant bifocal tumour was diagnosed by ultrasonography, digital mammography, magnetic resonance, and core-cut biopsy. The patient underwent planned conservative surgery (biquadrantectomy) with a sentinel node examination, but after results of the frozen section with positive resection margins and positive sentinel lymph nodes subsequent mastectomy with axillary lymph node dissection were realized. Histology in the resection specimen revealed two isolated and distinct tumours. One of the lesions represented conventional invasive ductal carcinoma of histological grade 3, and the second tumour was evaluated as invasive lipid-rich carcinoma, containing tumour cells with clear and foamy cytoplasm. Lipids in neoplastic cells were detected by Oil Red O staining and ultrastructural examination. Immunohistochemical analysis of both carcinomas was almost identical with negative steroid receptors, positive staining of HER-2, and p53 and with high proliferation activity (Ki-67). Mastectomy specimen contained residual foci of invasive ductal carcinoma and dissected axillary lymph nodes were free of metastasis. Patient underwent first cycles of chemotherapy with paclitaxel and Herceptin together with local radiotherapy and two month after surgery is without any evidence of the disease.

Minimal Sentinel Node Procedure for Staging Early Breast Cancer

2002 ◽  
Vol 88 (3) ◽  
pp. S45-S47 ◽  
Author(s):  
S Mariotti ◽  
O Buonomo ◽  
F Guadagni ◽  
A Spila ◽  
S Schiaroli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Regional Anesthesia ◽  
Early Breast Cancer ◽  
Frozen Section ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Sentinel Node Procedure ◽  
Time Saving ◽  
Identification Rate

Aims and Background Sentinel lymph node dissection (SLND) has recently been evaluated as a new staging technique for early breast cancer. To minimize the extent of surgery, the feasibility of eradicating primary breast lesions and the relative sentinel lymph nodes (SLN) under regional anesthesia was evaluated in this study. Methods and Study Design A selected population of 76 patients with suspected operable breast cancer and no clinically palpable lymph nodes was enrolled in the study. Intra- and perilesional administration of a radiotracer was performed. Lymphoscintigraphy was carried out to confirm the drainage pathway and locate the SLN. The following day, after inducing a nervous block induction of the ipsilateral intercostal nerves, we performed the surgical procedure with the help of a hand-held gamma-detecting probe. In case the primary lesion was diagnosed as invasive carcinoma by frozen section, the SLN and the remaining axillary lymph nodes (non-SLNs) were removed. The status of SLN and non-SLNs was compared. Results The primary breast lesion was located and excised in all cases (identification rate: 100%). Lymphoscintigraphy positively identified SLNs in 40/45 (89%) patients; in five patients no lymphatic drainage was detected. In 38 cases an average of 1.5 SLNs and 14 non-SLNs per patient were removed and pathologically analyzed; the remaining two patients showed SLNs in the internal mammary chain, which were not excised. Twenty-nine percent of the patients showed metastatic disease in the lymph nodes examined. Of all patients with affected nodes, 55% had cancer cells only in the SLN. No false negatives (skip metastases) were found. No immediate or long-term anesthesia-related complications (eg pleural lesions, intravascular injection) were observed. Conclusions Our data confirm the feasibility of single radiotracer administration for both occult lesion and SLN localization as well as the usefulness of SLND in staging early breast cancer. Regional anesthesia resulted in easy management and good patient compliance. This time-saving procedure allowed the completion of the whole surgical plan, reducing the recovery time without modifying the effectiveness of surgery.

scholarly journals Characterization of ex vivo healthy human axillary lymph nodes with high resolution 7 Tesla MRI

2010 ◽  
Vol 21 (2) ◽  
pp. 310-317 ◽  
Author(s):  
M. A. Korteweg ◽  
J. J. M. Zwanenburg ◽  
P. J. van Diest ◽  
M. A. A. J. van den Bosch ◽  
P. R. Luijten ◽  
...  
Keyword(s):  
High Resolution ◽  
Lymph Nodes ◽  
Ex Vivo ◽  
7 Tesla ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Healthy Human ◽  
7 Tesla Mri

Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging

2006 ◽  
Vol 103 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Stefano Ciatto ◽  
Beniamino Brancato ◽  
Gabriella Risso ◽  
Daniela Ambrogetti ◽  
Paolo Bulgaresi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Breast Cancer Staging ◽  
Needle Aspiration Cytology ◽  
Triage Test

scholarly journals Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging

2016 ◽  
Vol 32 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Muzaffer Akinci ◽  
Serap Pamak Bulut ◽  
Fazilet Erozgen ◽  
Mihriban Gurbuzel ◽  
Gokce Gulsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Biopsy ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Fine Needle ◽  
Breast Cancer Staging

scholarly journals Endosalpingiosis of Axillary Lymph Nodes: A Rare Histopathologic Pitfall with Clinical Relevance for Breast Cancer Staging

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Laila Nomani ◽  
Benjamin C. Calhoun ◽  
Charles V. Biscotti ◽  
Stephen R. Grobmyer ◽  
Charles D. Sturgis
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Cancer Staging ◽  
Axillary Lymph Nodes ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Axillary Lymph Node Status ◽  
Breast Cancer Staging ◽  
Immunohistochemical Studies

Establishment of accurate axillary lymph node status is of essential importance in determining both prognosis and the potential need for adjuvant therapy in patients with invasive breast cancer. Axillary lymph node heterotopias can in some cases result in overdiagnosis of metastatic disease. Nodal endosalpingiosis is perhaps the least commonly reported type of axially lymph node heterotopia. We herein illustrate a case in which second opinion pathologic interpretation combined with ancillary immunohistochemical studies allowed for a specific diagnosis of axillary nodal müllerian-type inclusions, confirming ypN0 staging and resulting in appropriate disease management and prognostication.

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