False-Positive Sentinel Lymph Nodes in Breast Cancer Patients Caused by Benign Glandular Inclusions : Report of Three Cases and Review of the Literature

• Published in: American journal of clinical pathology Vol. 130; no. 1; pp. 21 - 27
• Main Authors: YAN PENG, ASHFAQ, Raheela, EWING, Gene, LEITCH, A. Marilyn, MOLBERG, Kyle H
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.07.2008
• Subjects: Aged; Axilla; Biological and medical sciences; Breast Neoplasms - pathology; Carcinoma, Ductal, Breast - pathology; False Positive Reactions; Female; Hematologic and hematopoietic diseases; Humans; Investigative techniques, diagnostic techniques (general aspects); Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Nodes - pathology; Medical sciences; Middle Aged; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Sentinel Lymph Node Biopsy; Human; Immunohistochemistry; Breast disease; Inclusion; False positive; Axillary sentinel nodes; Sentinel lymph node; Biological marker; Malignant lymphadenopathy; Biological indicator; Malignant hemopathy; Breast cancer; Malignant tumor; False-positive; Case study; Lymph node metastasis; Mammary gland diseases; Breast carcinoma; Benign glandular inclusions; Anatomic pathology; Immunostains for myoepithelial markers; Axillary ganglion; Bibliographic review; Cancer
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/JVB8QFQNW5HBN7UJ

We report 3 cases of sentinel lymph nodes (SLNs) containing benign glandular inclusions (BGIs) in patients with breast carcinoma that were initially misdiagnosed as metastatic carcinoma. The first case had an SLN with glandular elements adjacent to a squamous inclusion cyst, the second had an SLN with a single complex gland showing apocrine features, and the third had 2 SLNs, each containing rare glands lined by bland columnar cells and surrounded by thin, fibrous bands. All glandular elements were distinctly different from the corresponding invasive carcinoma. Immunostains for myoepithelial markers revealed smooth muscle myosin reactivity and scattered p63+ nuclei, indicating the presence of myoepithelial cells. Based on morphologic and immunohistochemical findings, a diagnosis of BGIs was established. Our case series report indicates that comparison with the morphologic features of primary breast carcinoma and using immunohistochemical analysis for myoepithelial markers are important ancillary tools in distinguishing BGIs from metastatic carcinoma.