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Paracortical axillary sentinel lymph node ectopic breast tissue.

Debra L Zynger1, John C McCallum, Michael J Everton

  • 1Department of Pathology, Feinberg 7-325B, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, 251 East Huron Street, Chicago, IL 60611, USA. dzynger@usa.com

Pathology, Research and Practice
|January 27, 2009
PubMed
Summary
This summary is machine-generated.

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Benign ectopic breast tissue in axillary sentinel lymph nodes is rare and can mimic cancer. This case highlights features that can help pathologists distinguish benign inclusions from metastasis, preventing over-staging.

Area of Science:

  • Surgical pathology
  • Oncology
  • Diagnostic challenges in breast cancer sentinel lymph node biopsy

Background:

  • Benign glandular inclusions in axillary lymph nodes are uncommon.
  • Their presence in sentinel lymph nodes poses a risk of misdiagnosis as metastatic carcinoma.
  • Accurate interpretation is crucial for appropriate cancer staging and treatment.

Observation:

  • A 54-year-old female with ductal carcinoma in situ presented with findings in her sentinel lymph node biopsy.
  • The lymph node contained scattered, small glands lacking stroma in the paracortex, initially concerning for metastasis.
  • Deeper sections revealed larger areas of bland ducts and tubules with stroma, confirmed as benign ectopic breast tissue by immunohistochemistry.

Findings:

  • Benign glandular inclusions can occur in the paracortex of axillary sentinel lymph nodes.

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  • These benign inclusions may lack surrounding stroma, mimicking features of metastasis.
  • Histological features, including the presence of a myoepithelial layer, are key for differentiation.

    • Implications:

    • This case underscores the importance of considering benign ectopic breast tissue in the differential diagnosis of axillary lymph node findings.
    • Pathologists must be aware that paracortical location and absence of stroma do not exclusively indicate metastasis.
    • Accurate identification prevents potential over-staging and unnecessary treatment for breast cancer patients.