title: Coexistence of metastatic breast carcinoma and primary tuberculosis in axillary lymph nodes: a report of a rare case.
abstract: Concomitant breast cancer metastasis and tubercular lymphadenitis in axillary lymph node is an extremely rare occurrence. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma and the number of axillary nodes showing metastases alters the stage. As tuberculosis also produces nodal enlargement, this can mimic or complicate the staging of malignant disease. Dual pathology in an organ can lead to difficulties in interpretation and inappropriate treatment of tuberculosis as well as carcinoma breast. Moreover, fine needle aspiration cytology (FNAC) from such cases may be misleading if only one of the diseases is picked up. Therefore, the need for multiple attempts at FNAC should be stressed upon for all palpable lumps. We report a case of infiltrating duct carcinoma breast in a 45-year-old female where tuberculosis was discovered in axillary lymph nodes in addition to metastases. As the present case led to incidental discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexistent lesion in the pathologists' mind, especially in regions endemic for tuberculosis.
authors.forename: Mukta
authors.initials: M
authors.lastname: Pujani
authors.forename: Sabina
authors.initials: S
authors.lastname: Khan
authors.forename: Mohd Jaseem
authors.initials: MJ
authors.lastname: Hassan
authors.forename: Sujata
authors.initials: S
authors.lastname: Jetley
authors.forename: Prabhat Kumar
authors.initials: PK
authors.lastname: Raina
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D000995:Antitubercular Agents / Q000008:administration & dosage*; D001365:Axilla; D044963:Biopsy, Fine-Needle / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000379:methods*; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D000995:Antitubercular Agents
keywords: Metastasis; axillary lymph node; carcinoma breast; coexistence; tuberculosis