Abstract
We report a case of a 27-years-old woman with a lesion at the right breast, incidentally noted. The patient underwent tumour resection followed by a right mastectomy type “Patey”. Microscopic analysis of the tumour had recognised an invasive pleomorphic lobular carcinoma. Invasive pleomorphic lobular carcinoma (PLC) is a distinctive aggressive subtype of invasive lobular carcinomas (ILC). It has the typical infiltrating pattern of classical ILC of diffuse single cell spread but the nuclei aremore pleomorphic. Histological differential diagnosis with ductal carcinoma may be difficult, but it is important for this difference to be done. E-cadherine is a trans-membrane glycoprotein, typically expressed in ductal carcinoma, and loss of E-cadherine expression characterises invasive and in situ lobular carcinoma.
Résumé
Il s’agit d’une patiente âgée de 27 ans, admise pour un nodule indolore du quadrant supéroexterne dusein droit découvert fortuitement. L’examen clinique du nodule n’objectivait ni de rétraction du mamelon, ni d’écoulement mamelonnaire, ni d’adénopathie axillaire. La patiente bénéficiait d’une tumorectomie suivie d’une mastectomie de type Patey. L’examen anatomopathologique concluait à un carcinome lobulaire à cellules pléomorphes. Le carcinome lobulaire du sein à cellules pléomorphes est une variétérare du cancer mammaire récemment individualisée, dotée d’un potentiel évolutif particulièrementagressif. Il s’organise sur le plan architectural comme un cancer lobulaire invasif, avec cependant, un pléomorphisme cytonucléaire trè s marqué posant des problèmes de diagnostic différentiel avec le carcinome canalaire infiltrant peu différencié. L’E-cadhérine est d’un apport considérable, elle permet en effet de trancher entre ces deux entités dont les modalités thérapeutiques et évolutives sont très différentes.
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Azouz, H., Bouraoui, S., Blel, A. et al. Carcinome lobulaire à cellules pléomorphes du sein. Difficultés diagnostiques: à propos d’un cas avec revue de la littérature. Oncologie 10, 668–672 (2008). https://doi.org/10.1007/s10269-007-0788-9
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DOI: https://doi.org/10.1007/s10269-007-0788-9
Keywords
- Breast neoplasms
- Invasive lobular carcinoma
- Invasive pleomorph lobular carcinoma
- Invasive ductal carcinoma
- Immunochemistry