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Malignant Mesothelioma Mimicking Invasive Mammary Carcinoma in a Male Breast.

Desouki MM, Long DJ - Case Rep Oncol Med (2015)

Bottom Line: The cells were negative for MOC-31, BerEp4, ER, and PR.A final diagnosis of malignant mesothelioma, epithelioid type, was rendered.This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.

ABSTRACT
Malignant mesothelioma is an uncommon tumor with strong association with asbestos exposure. Few cases of malignant pleural mesothelioma metastatic to the female breast have been reported. Herein, we presented, for the first time, a case of locally infiltrating malignant pleural mesothelioma forming a mass in the breast of a male as the first pathologically confirmed manifestation of the disease. Breast ultrasound revealed an irregular mass in the right breast which involves the pectoralis muscle. Breast core biopsy revealed a proliferation of neoplastic epithelioid cells mimicking an infiltrating pleomorphic lobular carcinoma. IHC studies showed the cells to be positive for calretinin, CK5/6, WT1, and CK7. The cells were negative for MOC-31, BerEp4, ER, and PR. A final diagnosis of malignant mesothelioma, epithelioid type, was rendered. This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

No MeSH data available.


Related in: MedlinePlus

(a) Anteroposterior chest X-ray shows pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle. (b) A chest CT scan shows extensive pleural thickening on the right side and calcified pleural plaque on the left side. (c) A breast ultrasound shows an irregular, hypoechoic mass measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass involves pectoralis muscle and extends into the intercostal muscles. (d) Pleural biopsy shows plaque formation with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy.
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fig1: (a) Anteroposterior chest X-ray shows pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle. (b) A chest CT scan shows extensive pleural thickening on the right side and calcified pleural plaque on the left side. (c) A breast ultrasound shows an irregular, hypoechoic mass measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass involves pectoralis muscle and extends into the intercostal muscles. (d) Pleural biopsy shows plaque formation with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy.

Mentions: Anteroposterior chest X-ray showed pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle (Figure 1(a)). A chest CT scan with contrast demonstrated a contracted right hemithorax with an irregular pleural-based process that extends through the intercostal muscle and into the subcutaneous adipose tissue indicating direct spread rather than a metastasis in breast tissue. Bronchiectasis of right middle and lower lobes, right middle lobe atelectasis, and prior granulomatous disease have been also reported (Figure 1(b)). A diagnostic breast mammogram revealed predominantly fatty breast parenchyma and no morphologically abnormal lymph nodes in the axilla. A diagnostic breast ultrasound revealed an irregular, hypoechoic mass in the right breast with angular margins measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass appeared to involve the pectoralis muscle and possibly extended into the intercostal muscles (Figure 1(c)). Fine needle biopsy was recommended.


Malignant Mesothelioma Mimicking Invasive Mammary Carcinoma in a Male Breast.

Desouki MM, Long DJ - Case Rep Oncol Med (2015)

(a) Anteroposterior chest X-ray shows pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle. (b) A chest CT scan shows extensive pleural thickening on the right side and calcified pleural plaque on the left side. (c) A breast ultrasound shows an irregular, hypoechoic mass measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass involves pectoralis muscle and extends into the intercostal muscles. (d) Pleural biopsy shows plaque formation with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4581541&req=5

fig1: (a) Anteroposterior chest X-ray shows pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle. (b) A chest CT scan shows extensive pleural thickening on the right side and calcified pleural plaque on the left side. (c) A breast ultrasound shows an irregular, hypoechoic mass measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass involves pectoralis muscle and extends into the intercostal muscles. (d) Pleural biopsy shows plaque formation with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy.
Mentions: Anteroposterior chest X-ray showed pleural thickening along the right lateral chest wall and blunting of the right costophrenic angle (Figure 1(a)). A chest CT scan with contrast demonstrated a contracted right hemithorax with an irregular pleural-based process that extends through the intercostal muscle and into the subcutaneous adipose tissue indicating direct spread rather than a metastasis in breast tissue. Bronchiectasis of right middle and lower lobes, right middle lobe atelectasis, and prior granulomatous disease have been also reported (Figure 1(b)). A diagnostic breast mammogram revealed predominantly fatty breast parenchyma and no morphologically abnormal lymph nodes in the axilla. A diagnostic breast ultrasound revealed an irregular, hypoechoic mass in the right breast with angular margins measuring 5.6 × 2.9 × 3.6 cm. A portion of the mass appeared to involve the pectoralis muscle and possibly extended into the intercostal muscles (Figure 1(c)). Fine needle biopsy was recommended.

Bottom Line: The cells were negative for MOC-31, BerEp4, ER, and PR.A final diagnosis of malignant mesothelioma, epithelioid type, was rendered.This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.

ABSTRACT
Malignant mesothelioma is an uncommon tumor with strong association with asbestos exposure. Few cases of malignant pleural mesothelioma metastatic to the female breast have been reported. Herein, we presented, for the first time, a case of locally infiltrating malignant pleural mesothelioma forming a mass in the breast of a male as the first pathologically confirmed manifestation of the disease. Breast ultrasound revealed an irregular mass in the right breast which involves the pectoralis muscle. Breast core biopsy revealed a proliferation of neoplastic epithelioid cells mimicking an infiltrating pleomorphic lobular carcinoma. IHC studies showed the cells to be positive for calretinin, CK5/6, WT1, and CK7. The cells were negative for MOC-31, BerEp4, ER, and PR. A final diagnosis of malignant mesothelioma, epithelioid type, was rendered. This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

No MeSH data available.


Related in: MedlinePlus