PMC5694202_01
Ultrasound of the right axillary mass.. Notes: A low echo mass of 3.9x2.9 cm can be seen in the right axillary mammary gland. The boundary is still clear and the shape is irregular. A strong blood flow signal can be detected within it.
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An ultrasound examination confirmed an irregular hypoechoic solid mass in the right axillary cavity measuring 3.9 cm in the longest diameter (Figure 1).
Image of core needle biopsy histologic diagnosis using hematoxylin and eosin staining (original x100).. Note: Metastasis of poorly differentiated carcinoma can be seen in the resected right axillary lymph node tissue.
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A core needle biopsy revealed a poorly differentiated adenocarcinoma (Figure 2), which was likely of breast origin.
Preoperative facial photo of patient.. Note: Before surgery, the dermal erythematous papules on the right side of the lower eyelid are prominent.
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Three months before presentation to our department, the patient had developed periorbital erythematous papules, distributed over the lower eyelids, measuring 2.0x1.5 cm (Figure 3), which was diagnosed as DM by the rheumatology department.
Expression of ER/PR by IHC staining (original x100) and HER2 by FISH analysis (original x400).. Notes: (A) ER-negative expression can be detected by IHC staining. (B) PR-negative expression can be detected by IHC staining. (C) HER2-negative expression result can be detected by FISH analysis.. Abbreviations: ER, estrogen receptor; PR, progesterone receptor; IHC, immunohistochemistry; HER2, human epidermal growth factor receptor 2; FISH, fluorescent in situ hybridization.
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The IHC of the lymph node tissue was negative for estrogen receptor (Figure 4A), progesterone receptor (Figure 4B), prostate-specific antigen (PSA) (-), positive gross cystic disease fluid protein-15 (GCDFP-15), AE1/AE3, cytokeratin 7 (CK7), CK20, and human epidermal growth factor receptor 2 (HER2), while HER2 was amplified (negative) by FISH analysis (Figure 4C).
Postoperative facial photo of patient.. Note: Ten days after surgery, the dermal erythematous papules on the right side of the lower eyelid have nearly resolved.
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