Metastatic pleural mesothelioma presenting in a breast fine needle aspiration specimen

Our plain-English summary of Metastatic pleural mesothelioma presenting in a breast fine needle aspiration specimen, by P.W. Shield, D.L. Ribu (Cytopathology, 2017).

The study

• Authors: P.W. Shield, D.L. Ribu
• Journal: Cytopathology
• Published: 2017;28(5):429-431
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This case report, by authors based in Brisbane, Australia, described one 62-year-old woman. She was being treated with radiotherapy and chemotherapy for pleural mesothelioma when she developed a lump in her left breast. The irregular mass, about 1.5 by 2 cm, was considered suspicious for primary breast cancer. A fine needle aspiration (cells drawn out through a thin needle) showed large abnormal cells. It was reported as suspicious for malignancy, with features suggestive of metastatic mesothelioma, meaning mesothelioma that had spread from elsewhere. Two core biopsies taken a week later showed similar malignant cells in the breast tissue and no in situ carcinoma. Special stains (immunohistochemistry) confirmed that the cells were mesothelial. They were positive for calretinin and CK5 and negative for CEA, ER and PR. The article did not report whether this patient had been exposed to asbestos. The authors believed this to be the first malignant mesothelioma in a female breast reported on fine needle aspiration cytology. They said the case shows why metastatic disease should be considered when breast samples look unusual, and the value of immunohistochemistry.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 62-year-old woman undergoing radiotherapy and chemotherapy for pleural mesothelioma, who developed a lump in her left breast
• Exposure: Not reported for this patient. The article mentions asbestos only in general terms in its introduction.
• Main results:
  • The patient presented with a palpable, discrete lump in the left breast. The irregular mass, about 1.5 by 2 cm, was considered suspicious for primary breast carcinoma.
  • The fine needle aspiration sample was reported as suspicious for malignancy, with features suggestive of metastatic mesothelioma.
  • Two core biopsies collected 1 week later showed breast tissue partially permeated by nests of malignant cells similar to those in the aspiration sample, with no evidence of in situ carcinoma.
  • Immunohistochemistry confirmed the mesothelial nature of the cells. They were positive for calretinin and CK5 and showed EMA staining in a thick membrane pattern. CEA, ER and PR were negative.
• The authors' conclusion: The authors believed this to be the first malignant mesothelioma in a female breast reported on fine needle aspiration cytology. They said the case illustrates the need to consider metastatic disease in malignant breast aspiration cases with unusual morphology, and the value of immunohistochemistry.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Electron microscopy in the diagnosis of percutaneous fine needle aspiration specimens — E.J. Wills, S. Carr, et al. (1987)
• Malignant mesothelioma presenting as a breast mass — A. Aujayeb, H. Clague, et al. (2012)
• Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology — J.G. Nasit, G. Dhruva (2014)
• Fine needle aspiration cytology of well-differentiated papillary mesothelioma: a case report — Y. Gong, R. Ren, et al. (2005)
• Fine-needle aspiration of a well-differentiated papillary mesothelioma in the inguinal hernia sac: A case report and review of literature — Y.Y. Wheeler, F. Burroughs, et al. (2009)
• Fine needle aspiration cytology in malignant mesothelioma of the tunica vaginalis testis — R. Gupta, P. Dey, et al. (2011)

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