Endosalpingiosis in axillary lymph nodes: A possible pitfall in the staging of patients with breast carcinoma Journal Article
| Authors: | Corben, A. D.; Nehhozina, T.; Garg, K.; Vallejo, C. E.; Brogi, E. |
| Article Title: | Endosalpingiosis in axillary lymph nodes: A possible pitfall in the staging of patients with breast carcinoma |
| Abstract: | The occurrence of benign epithelial inclusions in lymph nodes is well documented and can sometimes mimic metastatic carcinoma. Benign müllerian inclusions, such as endometriosis and endosalpingiosis, are common in pelvic and para-aortic lymph nodes, but their presence in supradiaphragmatic lymph nodes is a rare event. We report our experience with 3 patients found to have endosalpingiosis in axillary sentinel lymph nodes obtained for staging of breast carcinoma. All patients were postmenopausal women, with age ranging between 65 and 75 years. Endosalpingiosis involved a single lymph node in 1 patient, and 2 nodes in each of the other 2; it was present in the lymph node capsule in all the 3 cases, with few glands scattered within the lymph node parenchyma in 2 of the patients. The glands contained ciliated and intercalated peg cells, had no periglandular endometrial-type stroma, and showed no atypia or mitotic activity. The epithelium demonstrated positive nuclear immunoreactivity for WT1 and PAX8, and was devoid of myoepithelium or basement membrane. Endosalpingiosis had been misinterpreted as metastatic carcinoma at another hospital in 1 of the 3 patients, with subsequent dissection of 19 additional benign axillary lymph nodes. We conclude that endosalpingiosis can involve axillary lymph nodes and closely simulate metastatic mammary carcinoma. Morphologic identification of ciliated cells and "peg" cells is most helpful to recognize this benign inclusion, and positive immunoreactivity for WT1 and/or PAX8 can be used to support the diagnosis. © 2010 by Lippincott Williams & Wilkins. |
| Keywords: | immunohistochemistry; aged; aged, 80 and over; cancer staging; lymph node metastasis; lymph nodes; lymphatic metastasis; neoplasm staging; sentinel lymph node biopsy; metastasis; tumor markers, biological; pathology; breast neoplasms; tumor marker; chemistry; diagnostic errors; breast tumor; lymph node; carcinoma; prediction and forecasting; predictive value of tests; diagnostic error; epithelium cell; epithelial cells; wt1 protein; eukaryotic flagellum; cilia; paired box transcription factor; paired box transcription factors; unnecessary procedures; unnecessary procedure; axillary sentinel lymph node; benign glandular inclusion; endosalpingiosis; pax8 protein, human; wt1 proteins |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 34 |
| Issue: | 8 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2010-08-01 |
| Start Page: | 1211 |
| End Page: | 1216 |
| Language: | English |
| DOI: | 10.1097/PAS.0b013e3181e5e03e |
| PUBMED: | 20631604 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: AJSPD" - "Source: Scopus" |
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