PMC6512030_01
PA chest radiograph showing a large left-sided pleural effusion (arrow).
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Chest radiography showed a large left-sided and small right-sided pleural effusions (Figure 1).
Computed tomography with angiography showing a right medial breast mass (closed white arrow) with mediastinal (open white arrow) and axillary lymphadenopathy. Large effusions greater on the left (P).
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Computed tomography (CT) with angiography revealed a right medial breast mass, mediastinal and axillary lymphadenopathy, and bilateral effusions, greater on the left (Figure 2).
Hematoxylin and eosin stain showing invasive carcinoma consisting of pleomorphic tumor cells with vacuolated and eosinophilic cytoplasm and prominent nucleoli.
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fig3
Pathology from both breast tissue samples revealed Mullerian epithelial primary, consistent with metastatic clear-cell carcinoma of the ovary (Figures 3 and 4).
(a) PAX-8: strong, diffuse nuclear staining within tumor cells is consistent with a Mullerian primary and militates against lung primary. (b) Napsin-A: focal granular cytoplasmic staining, consistent with either lung or clear-cell Mullerian-type adenocarcinoma.
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fig4
Pathology from both breast tissue samples revealed Mullerian epithelial primary, consistent with metastatic clear-cell carcinoma of the ovary (Figures 3 and 4).