Primary breast carcinoma with features of the follicular variant of papillary thyroid carcinoma

Nektarios Koufopoulos, K. Kapatou, F. Antoniadou, D. Nasikas, I. Karaitianos, S. Kokkali, D. Nasi, L. Khaldi
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Abstract

A 61-year-old female patient with no previous medical history presented to our hospital with a palpable right breast mass as well as palpable axillary lymph nodes. Microscopic examination revealed a bifocal primary carcinoma of the breast displaying characteristics similar to that of follicular variant of papillary thyroid carcinoma. Three axillary lymph nodes contained metastases. Immunohistochemical study for TTF-1, Thyroglobulin, GATA-3, ER and PR was consistent with a primary breast carcinoma, excluding the possibility of a metastatic tumor. The above unusual morphological features were caused by improper fixed tissue. Suboptimal fixation may cause tissue artifacts such as shrinkage, streaming, diffusion, vacuolation and nuclear or cytoplasmic changes as well as decreasing tissue antigenicity. Occasionally, altered morphology may mislead to major diagnostic pitfall.
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具有滤泡型甲状腺乳头状癌特征的原发性乳腺癌
患者61岁,女,无既往病史,右乳房肿块可触及,腋窝淋巴结可触及。镜下检查发现双焦点原发性乳腺癌,表现出与滤泡型甲状腺乳头状癌相似的特征。三个腋窝淋巴结有转移。免疫组化检查TTF-1、甲状腺球蛋白、GATA-3、ER和PR与原发性乳腺癌一致,排除转移瘤的可能性。上述异常形态特征是由于固定组织不正确所致。次优固定可能导致组织伪影,如收缩、流动、扩散、空泡化、细胞核或细胞质改变以及组织抗原性降低。偶尔,形态学的改变可能会误导主要的诊断缺陷。
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