Limits...
Diagnosis: 64 y.o. female with recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.

Patterson RAP - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Diagnosis: 64 y.o. female with recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.

History: History (can include gestational age, or age in days, weeks, months): 64 y.o. WF with hx of Breast CA (1996), s/p lumpectomy and XRT, admitted for workup of fatigue, 15-20 lb weight loss in 8 months, and increased abdominal girth in the setting of imaging studies, which show ascites (with peritoneal fluid negative for malignant cells), liver lesions, and multiple lung masses. Prior workup demonstrated elevated LFTs, Elevated CEA, CA 19-9, CA 125, and negative viral hepatitis panels.

Findings: Image Findings: 1. PET scan—2 hypermetabolic foci in Left breast; Focal hypermetabolic uptake in inferior Right liver lobe and Left liver lobe with diffuse/heterogeneous uptake in Right lobe; diffuse bone uptake in axial/appendicular skeleton that is nonspecific: malignant vs liver failure. 2. MRCP/MRI abdomen—liver cirrhosis and portal HTN leading to splenomegaly and ascites; no pancreatic ductal dilatation; liver lesions are peripheral with capsular retraction 3. CT chest—too numerous to count non-calcified nodules in lungs; Left breast lesion and axillary lymph node 4. Breast U/S (image not available for MedPix) used for core Bx—1.2cm lesion in Left upper outer breast; BIRADS category 5

Ddx: Differential Diagnosis for these findings in this case: 1. Liver lesions and ascites: Periportal fibrosis, cirrhosis leading to HCC, regenerating nodules, inflammation, neoplastic infiltration in interstitium 2. Lung nodules: metastasis, infectious, granulomatous, TB, mycobacterial 3. Breast lesions: primary lesion, metastasis

Exam: Physical Exam and Laboratory: Pertinent Physical Findings: Abdomen--distended, non-tender, ascites present, no organomegaly detected. Exam otherwise benign. Lab Findings: Chem7—141/5.0/105/31/12/0.6/112; CBC—8.7/11.0/34.0/181; Coag PT 12.8/PTT 27.8; LFTs—AlkPhos 1052/AST 233/ ALT 91/ Tbili 2.7 Tumor markers: CA 27-29 1371 (normal 0-37), CA 15-3 1464 (normal 0-31), CA 125 196 (normal 0-34), AFP normal Histology of Breast Bx: Infiltrating Ductal CA T3N2M2 Histology of Liver Bx: Adenocarcinoma; Special stains include cytokeratin 7: positive, cytokeratin 20: negative, progesterone/estrogen: positive, CEA: focally positive, Thyroid transcription factor 1: negative.

No MeSH data available.


Recurrent breast cancer with metastasis to lymph nodes and lungs.  Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX2386&req=5

MPX2386_synpic23829: Recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.


Diagnosis: 64 y.o. female with recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.

Patterson RAP - MedPix

Recurrent breast cancer with metastasis to lymph nodes and lungs.  Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2386&req=5

MPX2386_synpic23829: Recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Diagnosis: 64 y.o. female with recurrent breast cancer with metastasis to lymph nodes and lungs. Liver mass biopsy reveals adenocarcinoma, with histology consistent with breast tissue.

History: History (can include gestational age, or age in days, weeks, months): 64 y.o. WF with hx of Breast CA (1996), s/p lumpectomy and XRT, admitted for workup of fatigue, 15-20 lb weight loss in 8 months, and increased abdominal girth in the setting of imaging studies, which show ascites (with peritoneal fluid negative for malignant cells), liver lesions, and multiple lung masses. Prior workup demonstrated elevated LFTs, Elevated CEA, CA 19-9, CA 125, and negative viral hepatitis panels.

Findings: Image Findings: 1. PET scan—2 hypermetabolic foci in Left breast; Focal hypermetabolic uptake in inferior Right liver lobe and Left liver lobe with diffuse/heterogeneous uptake in Right lobe; diffuse bone uptake in axial/appendicular skeleton that is nonspecific: malignant vs liver failure. 2. MRCP/MRI abdomen—liver cirrhosis and portal HTN leading to splenomegaly and ascites; no pancreatic ductal dilatation; liver lesions are peripheral with capsular retraction 3. CT chest—too numerous to count non-calcified nodules in lungs; Left breast lesion and axillary lymph node 4. Breast U/S (image not available for MedPix) used for core Bx—1.2cm lesion in Left upper outer breast; BIRADS category 5

Ddx: Differential Diagnosis for these findings in this case: 1. Liver lesions and ascites: Periportal fibrosis, cirrhosis leading to HCC, regenerating nodules, inflammation, neoplastic infiltration in interstitium 2. Lung nodules: metastasis, infectious, granulomatous, TB, mycobacterial 3. Breast lesions: primary lesion, metastasis

Exam: Physical Exam and Laboratory: Pertinent Physical Findings: Abdomen--distended, non-tender, ascites present, no organomegaly detected. Exam otherwise benign. Lab Findings: Chem7—141/5.0/105/31/12/0.6/112; CBC—8.7/11.0/34.0/181; Coag PT 12.8/PTT 27.8; LFTs—AlkPhos 1052/AST 233/ ALT 91/ Tbili 2.7 Tumor markers: CA 27-29 1371 (normal 0-37), CA 15-3 1464 (normal 0-31), CA 125 196 (normal 0-34), AFP normal Histology of Breast Bx: Infiltrating Ductal CA T3N2M2 Histology of Liver Bx: Adenocarcinoma; Special stains include cytokeratin 7: positive, cytokeratin 20: negative, progesterone/estrogen: positive, CEA: focally positive, Thyroid transcription factor 1: negative.

No MeSH data available.