False-positive sentinel lymph nodes in breast cancer patients caused by benign glandular inclusions

Report of three cases and review of the literature

Yan Peng, Raheela Ashfaq, Gene Ewing, A. Marilyn Leitch, Kyle H. Molberg

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

We report 3 cases of sentinel lymph nodes (SLNs) containing benign glandular inclusions (BGIs) in patients with breast carcinoma that were initially misdiagnosed as metastatic carcinoma. The first case had an SLN with glandular elements adjacent to a squamous inclusion cyst, the second had an SLN with a single complex gland showing apocrine features, and the third had 2 SLNs, each containing rare glands lined by bland columnar cells and surrounded by thin, fibrous bands. All glandular elements were distinctly different from the corresponding invasive carcinoma. Immunostains for myoepithelial markers revealed smooth muscle myosin reactivity and scattered p63+ nuclei, indicating the presence of myoepithelial cells. Based on morphologic and immunohistochemical findings, a diagnosis of BGIs was established. Our case series report indicates that comparison with the morphologic features of primary breast carcinoma and using immunohistochemical analysis for myoepithelial markers are important ancillary tools in distinguishing BGIs from metastatic carcinoma.

Original languageEnglish (US)
Pages (from-to)21-27
Number of pages7
JournalAmerican Journal of Clinical Pathology
Volume130
Issue number1
DOIs
StatePublished - Jul 2008

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Breast Neoplasms
Carcinoma
Apocrine Glands
Smooth Muscle Myosins
Diagnostic Errors
Cysts
Sentinel Lymph Node

Keywords

  • Axillary sentinel nodes
  • Benign glandular inclusions
  • Breast carcinoma
  • False-positive
  • Immunostains for myoepithelial markers

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

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abstract = "We report 3 cases of sentinel lymph nodes (SLNs) containing benign glandular inclusions (BGIs) in patients with breast carcinoma that were initially misdiagnosed as metastatic carcinoma. The first case had an SLN with glandular elements adjacent to a squamous inclusion cyst, the second had an SLN with a single complex gland showing apocrine features, and the third had 2 SLNs, each containing rare glands lined by bland columnar cells and surrounded by thin, fibrous bands. All glandular elements were distinctly different from the corresponding invasive carcinoma. Immunostains for myoepithelial markers revealed smooth muscle myosin reactivity and scattered p63+ nuclei, indicating the presence of myoepithelial cells. Based on morphologic and immunohistochemical findings, a diagnosis of BGIs was established. Our case series report indicates that comparison with the morphologic features of primary breast carcinoma and using immunohistochemical analysis for myoepithelial markers are important ancillary tools in distinguishing BGIs from metastatic carcinoma.",
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AU - Ewing, Gene

AU - Leitch, A. Marilyn

AU - Molberg, Kyle H.

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