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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

Histopathology and immunoprofile of the metastatic malignant mesothelioma to the breast. ((a) and (b)) Representative H&E captions from the metastatic malignant mesothelioma in the breast biopsy which show proliferation of neoplastic epithelioid cells forming cords and nests which infiltrate the breast parenchyma and skeletal muscles. The neoplastic cells are round to polygonal with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli. The neoplastic cells are positive for WT1 (inset in (b)), calretinin (c), and CK5/6 (d).
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fig2: Histopathology and immunoprofile of the metastatic malignant mesothelioma to the breast. ((a) and (b)) Representative H&E captions from the metastatic malignant mesothelioma in the breast biopsy which show proliferation of neoplastic epithelioid cells forming cords and nests which infiltrate the breast parenchyma and skeletal muscles. The neoplastic cells are round to polygonal with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli. The neoplastic cells are positive for WT1 (inset in (b)), calretinin (c), and CK5/6 (d).

Mentions: Biopsy from the right pleural decortication described grossly as a fragment of red-tan tissue measuring 0.9 × 0.7 × 0.2 cm was entirely submitted in one cassette. Microscopic examination was performed at an outside facility and reviewed by expert lung pathologists in consensus at our institution subsequent to the diagnosis of the breast lesion and reported as pleural plaque with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy (Figure 1(d)). Breast needle core biopsy revealed a proliferation of neoplastic epithelioid cells in cords and nests infiltrating breast parenchyma and skeletal muscles. The neoplastic cells were round to polygonal in shape with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli mimicking an infiltrating pleomorphic lobular carcinoma (Figures 2(a) and 2(b)). There were focal gland-like and micropapillary structures. Rare mitotic activity was present.


Malignant Mesothelioma Mimicking Invasive Mammary Carcinoma in a Male Breast.

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

Histopathology and immunoprofile of the metastatic malignant mesothelioma to the breast. ((a) and (b)) Representative H&E captions from the metastatic malignant mesothelioma in the breast biopsy which show proliferation of neoplastic epithelioid cells forming cords and nests which infiltrate the breast parenchyma and skeletal muscles. The neoplastic cells are round to polygonal with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli. The neoplastic cells are positive for WT1 (inset in (b)), calretinin (c), and CK5/6 (d).
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4581541&req=5

fig2: Histopathology and immunoprofile of the metastatic malignant mesothelioma to the breast. ((a) and (b)) Representative H&E captions from the metastatic malignant mesothelioma in the breast biopsy which show proliferation of neoplastic epithelioid cells forming cords and nests which infiltrate the breast parenchyma and skeletal muscles. The neoplastic cells are round to polygonal with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli. The neoplastic cells are positive for WT1 (inset in (b)), calretinin (c), and CK5/6 (d).
Mentions: Biopsy from the right pleural decortication described grossly as a fragment of red-tan tissue measuring 0.9 × 0.7 × 0.2 cm was entirely submitted in one cassette. Microscopic examination was performed at an outside facility and reviewed by expert lung pathologists in consensus at our institution subsequent to the diagnosis of the breast lesion and reported as pleural plaque with dense fibrosis, minimal inflammation, and dystrophic calcification with no evidence of malignancy (Figure 1(d)). Breast needle core biopsy revealed a proliferation of neoplastic epithelioid cells in cords and nests infiltrating breast parenchyma and skeletal muscles. The neoplastic cells were round to polygonal in shape with moderate cytoplasm, moderate cytologic pleomorphism, and occasional nucleoli mimicking an infiltrating pleomorphic lobular carcinoma (Figures 2(a) and 2(b)). There were focal gland-like and micropapillary structures. Rare mitotic activity was present.

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