Morphologic Mimics of Invasive Lobular Carcinoma

Ishikawa, Martin K.; Pinsky, Renee W.; Smith, Lauren B.; Jorns, Julie M.

doi:10.5858/arpa.2015-0190-ra

Cited by 12 publications

(7 citation statements)

References 62 publications

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“…This pattern has also been observed in adenocarcinomas arising from other sites such as the breast, lung, pancreaticobiliary tract, Mullerian tract, and other less common sites. In the breast, signet-ring carcinoma is not typically recognized as a specific entity although the morphology may give rise to diagnostic challenges in certain situations [1, 2, 3].…”

Section: Introductionmentioning

confidence: 99%

Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers

et al. 2018

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Signet ring morphology is recognized throughout the gastrointestinal tract. However, this pattern may be observed in other primary sites giving rise to diagnostic challenges in the work-up of metastases. Relatively newer immunohistochemical markers have not been evaluated in this context. We assessed expression patterns of several common immunohistochemical markers in tumors with Signet ring morphology to delineate a pragmatic approach to this differential diagnosis. Primary breast and gastrointestinal carcinomas showing Signet ring features were reviewed. Non-mammary and non-gastrointestinal tumors with this morphology were included for comparison. Estrogen receptor (ER), progesterone receptor (PR), E-cadherin, CK7, CK20, GCDFP-15, mammaglobin, CDX2, GATA-3, and HepPar-1 immunohistochemistry was performed. Expression patterns were compared between breast and gastrointestinal tumors as well as lobular breast and gastric tumors. Ninety-three cases were identified: 33 breast carcinomas including 13 lobular, 50 gastrointestinal tumors including 23 gastric, and 10 from other sites. ER (sensitivity=81.8%, specificity=100%, positive predictive value (PPV)=100%, negative predictive value (NPV)=89.3%) and GATA-3 (sensitivity=100%, specificity=98%, PPV=96.8%, NPV=100%) expression were associated with breast origin. CK20 (sensitivity=66.7%, specificity=93.3%, PPV=94.1%, NPV=63.6%) and CDX2 (sensitivity=72%, specificity=100%, PPV=100%, NPV=68.9%) demonstrated the strongest discriminatory value for gastrointestinal origin. These markers exhibited similar discriminatory characteristics when comparing lobular and gastric signet ring carcinomas. In a limited trial on metastatic breast and gastric cases, these markers successfully discriminated between breast and gastric primary sites in 15 of 16 cases. ER and GATA-3 are most supportive of mammary origin and constitute an effective panel for distinguishing primary breast from primary gastrointestinal Signet ring tumors when combined with CK20 and CDX2 immunohistochemistry.

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Section: Introductionmentioning

confidence: 99%

Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers

et al. 2018

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“…Also, cell morphology can be diverse, from monomorphous appearing cells with little cytoplasm, to plasmacytoid cells, signet ring cells, and pleomorphic nucleated cells [14,15]. The particular plasmacytoid morphotype can cause problems in patients with a history of plasma cell myeloma, such as the one reported by us, even if the lesion is located in the breast or bone, marrow or any other site-reports of such confusing lesions with aberrant CD138 expression rely on detailed immunohistochemical analysis to elucidate the diagnosis [12,13]. Lobular carcinomas contain, most of the time, an admixture of cells including plasmacytoid cells and many times express CD138 not only at membrane level, but are also aberrantly cytoplasmic.…”

Section: Discussionmentioning

confidence: 99%

“…An associated expression of CD138 and light chains in an epithelial neoplasm poses a serious diagnostic challenge, especially in discohesive types of tumors including plasmacytoid phenotypes, such as those originating in the digestive tract, most often in the stomach, and invasive lobular carcinomas. In cases where a prior diagnosis of plasma cell myeloma exists, immunohistochemistry proves a reliable tool to separate carcinomas masquerading as plasma cell myeloma and vice-versa [12,13]. For such presentations, an extensive panel of antibodies should be employed in order to specifically characterize carcinomas, including various cytokeratins and less EMA (epitelial membrane antigen) (expressed by most plasma cell myelomas), and also hematological markers that should not be expressed (CD79a and MUM1).…”

Section: Introductionmentioning

confidence: 99%

Rare Breast Carcinoma with Paradoxical Plasma Cell Immunoprofile: A Case Report

Grădinaru

Stoicea²,

Mocanu³

et al. 2020

Medicina

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Plasma cell features are encountered in a variety of non-plasma cell neoplasias, especially carcinomas of a discohesive type, such as those occurring in the digestive tract and breast. Lobular carcinomas of the breast present themselves in a variety of architectural patterns and many cell morphologies, including plasmacytoid types. A matching plasma cell phenotype is sometimes an associated feature. We report a case of a moderate grade invasive lobular carcinoma with focal plasmacytoid morphology and aberrant expression of plasma cell markers in a patient previously diagnosed with multiple myeloma. Paradoxical plasma cell immunoprofiles can be encountered in many malignancies, causing serious diagnostic problems, even more so with those occurring in discohesive carcinomas in multiple myeloma patients.

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“…Among reports of hematoxylin and eosin (H&E) staining of breast tissues, similar features in the three hematologic malignancies were noted. Discohesive cells, often aligned along and between collagen fibers in single-file, can be seen in all hematologic tumors [4][5][6] (Figure 1). The linear arrangement has been called a "metastatic highway" toward blood vessels, and is classic for invasive lobular breast cancer (ILC).…”

Section: Presentationmentioning

confidence: 99%

Single organ microenvironment and the common features of tumors of leukemia, lymphoma, and myeloma cells growing there: A literature review

Cunningham

Sosa²,

Hamele‐Bena

2021

European J of Haematology

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The tumor manifestations of leukemia, lymphoma, and multiple myeloma in body organs have been described for over a century.While the natural histories of each type of solid tumor is well known, that of hematologic tumors in the same organ site have not been elucidated. Knowledge of hematologic tumors has been limited to their description in individual case reports of tumors in any organ.The natural history of hematologic tumors in individual sites and their metastatic patterns has not been tracked, except for tumors at a few sites. Similar patterns of growth and spread between leukemic and solid tumors in breast, ovary, and GI sites were revealed. [1][2][3] Extensive studies of leukemic breast tumors and specimen analyses found histologic and genetic similarities of leukemic to solid breast cancers. 4 The present literature review was undertaken to ascertain

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Morphologic Mimics of Invasive Lobular Carcinoma

Cited by 12 publications

References 62 publications

Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers

Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers

Rare Breast Carcinoma with Paradoxical Plasma Cell Immunoprofile: A Case Report

Single organ microenvironment and the common features of tumors of leukemia, lymphoma, and myeloma cells growing there: A literature review

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