title: Extramedullary haematopoiesis in axillary lymph nodes following neoadjuvant chemotherapy for locally advanced breast cancer.
abstract: We report the case of a 53-year-old lady who presented with a lump in her left breast. Her initial investigations demonstrated a grade III invasive ductal carcinoma of the breast that was tethered to the pectoralis major; imaging and cytology also revealed metastatic nodes in the left axilla. After undergoing neoadjuvant chemotherapy with evidence of clinical and radiological tumour response, a wire-guided wide local excision and axillary node clearance was performed. When a histological analysis of the specimen was performed, there was no evidence of a viable metastatic tumour in the axillary lymph nodes, but there were several areas of extramedullary haematopoiesis. There are only two other reports in the literature of this finding. This could represent a potential source of false-positive diagnosis of axillary metastasis from breast cancer. It would be prudent to consider biopsy prior to clearance if there are megakaryocytes in axillary node cytology.
authors.affiliation: Department of Breast & General Surgery, St George's Healthcare National Health Service Trust, London, UK.
authors.forename: Arunjit Singh
authors.initials: AS
authors.lastname: Takhar
authors.forename: Alex
authors.initials: A
authors.lastname: Ney
authors.forename: Meera
authors.initials: M
authors.lastname: Patel
authors.forename: Anup
authors.initials: A
authors.lastname: Sharma
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001365:Axilla / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003581:Cytodiagnosis; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008533:Megakaryocytes; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging
chemical_list: D000970:Antineoplastic Agents