Neuroendocrine tumor of the breast showing invasive micropapillary features and multiple lymph node metastases

被引:3
作者
Kawasaki, Tomonori [1 ,2 ,3 ,4 ,7 ]
Tashima, Tomoaki [1 ]
Muramatsu, Chisako [5 ]
Fujimoto, Akihiro [1 ]
Usami, Yoko [1 ]
Kodama, Hitomi
Ichikawa, Jiro [3 ]
Nagai, Hirokazu [2 ,4 ]
Taniyama, Kiyomi [6 ]
机构
[1] Saitama Med Univ, Int Med Ctr, Comprehens Canc Ctr, Hidaka, Japan
[2] Saitama Sekishinkai Hosp, Breast Oncol Team, Sayama, Japan
[3] Univ Yamanashi, Grad Sch Med, Chuo, Japan
[4] Nagoya Med Ctr, Natl Hosp Org NHO, Clin Res Ctr, Nagoya, Aichi, Japan
[5] Shiga Univ, Fac Data Sci, Hikone, Japan
[6] Chugoku Canc Ctr, NHO Kure Med Ctr, Dept Diagnost Pathol, Hiroshima, Japan
[7] Saitama Med Univ, Int Med Ctr, Dept Pathol, 1397 1 Yamane Hidaka, Saitama 3501298, Japan
关键词
breast; invasive micropapillary carcinoma; neuroendocrine neoplasm; neuroendocrine tumor; CARCINOMA; DIFFERENTIATION;
D O I
10.1002/cnr2.1775
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundHerein, for the first time, we present a case with mixed invasive micropapillary and neuroendocrine mammary neoplasm. CaseThe patient, a 65-year-old postmenopausal woman, had become aware of a tumor in her right breast 11 months prior to presentation at our hospital. The cut surface of the mastectomy specimen contained a well-circumscribed, multinodular, red-brown tumor, measuring 15x15x15 cm. Histopathologically, this solid cystic lesion consisted of medullary growth of cancer cells accompanied by a well-developed vascular network as well as conspicuous hemorrhage. Cancer cell nests of various sizes displayed an "inside-out" structure surrounded by empty spaces. Most cancer cells were polygonal, though a few were short fusiform-shaped, and possessed finely granular, eosinophilic cytoplasm and ovoid, fine-granular nuclei. Eighteen mitotic figures were observed in 10 high-power fields. Macrometastases, up to 13x8 mm in size, with the same morphological features as the original tumor site, were identified in 3 of 15 dissected right axillary nodes. Immunohistochemically, primary and metastatic cancer cells were diffusely positive for chromogranin A and the estrogen receptor (Allred's total score: 8) and focally reactive for synaptophysin and the progesterone receptor (total score: 5). HER2 and cytokeratin 5/6 were negative, and the MIB-1 labelling index was 36.2%. MUC1 and EMA lined the stroma-facing surfaces of the cell membranes, indicating reversed polarity. ConclusionOur current patient, who had an invasive breast carcinoma with concomitant neuroendocrine and micropapillary features, developed multiple nodal metastases in association with a large-diameter tumor showing a luminal B-like immuno-profile. Accordingly, meticulous clinical follow-up remains essential for this uncommon case.
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