Pathochistological and immunohistochemical study in small intestine metastasis as first clinical expression of invasive lobular breast carcinoma: Prognosis and complex treatment

The gastrointestinal metastases (GIM) of breast carcinoma (BC) are a rare clinical finding, even more rarely diagnosed as initial symptoms at unknown BC. We present a 50-year-old woman with metastases in the terminal ileum combined with multiple bone metastases from an unknown invasive carcinoma of left mammary gland. Gastrointestinal metastases are rarely observed in invasive lobular breast carcinoma. Differential diagnosis between intestinal metastases from primary BC and primary intestinal neoplasm is extremely difficult. Determination of tumor pathohistogenesis require careful pathohistological and immunohistochemical analysis. Complex treatment follows the primary neoplasm principles. The prognosis in such clinical cases is unfavorable, but after timely complex oncological treatment, including emergency operation, chemotherapy, hormone and target therapy, 36 monthly survival is achieved. Keywords: gastrointestinal metastases; invasive lobular breast carcinoma; pathohistological analysis; immunohistochemical analysis; complex treatment.

Equine Intestinal Lymphoma: Clinical-Pathological Features, Immunophenotype, and Survival

Lymphoma is the most common intestinal neoplasm in horses, but its clinical-pathological features are poorly characterized. Primary intestinal lymphoma was diagnosed in 20 horses on biopsy samples and further confirmed by postmortem examination in 16 cases. Lymphoma was found in the small intestine in 12 of 20 (60%), in the colon in 5 of 20 (25%), and in both small and large intestines in 3 of 20 (15%) cases. Gross findings included thickening of the intestinal wall (45%), mural nodules or masses (30%), and both thickening and nodules (10%). Cases were classified according to the human World Health Organization classification as enteropathy-associated T-cell lymphoma (EATL) type 1 (40%), EATL type 2 (45%), and T-cell-rich large B-cell lymphoma (TCRLBCL) (15%). With respect to histologic grade, 70% of cases were grade 1 and 30% were grade 2. Of EATLs, the infiltrate was mucosal only (12%), mucosal and submucosal (53%), or transmural (35%). EATL1 was submucosal to transmural (2/8 and 6/8), EATL2 was mucosal to submucosal (3/9 and 6/9), and TCRLBCL was always transmural. Epitheliotropism was present in most EATLs and characterized by single-cell infiltrates within the epithelium in EATL1 and intraepithelial clusters or plaques in EATL2. Median survival was 25 days for EATL1, 90 days for EATL2, and 187.5 days for TCRLBCL; differences were not statistically significant. Of the EATLs, grade 1 had a median survival of 60 days and grade 2 had a median survival of 25 days; differences were not statistically significant.