PMC7670084_01
(A-C) No.3, A 31-year-old female with lung adenocarcinoma metastasis. The ultrasound shows an irregular indistinct and homogeneous hypoechoic mass in the central area of the left breast with the long axis parallel to the skin (A), color Doppler flowing imaging shows rich blood flow signals inside and vessels in rim (B) and ipsilateral abnormal axillary lymph nodes show metastasis (C). (D) No.11, A 55-year-old female with ovary serous papillary adenocarcinoma. The ultrasound shows an irregular indistinct hypoechoic mass in the upper outer quadrant of the right breast with no posterior features. (E and F) No.2, A 81-year-old male with lung adenocarcinoma metastasis. The ultrasound shows an irregular indistinct and heterogeneous hypoechoic mass in the central area of the left breast with the long axis non-parallel to the skin (E) and color Doppler flowing imaging shows no internal blood flow signals (F) and posterior features are combined pattern (E and F).
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Of the 14 cases, 13 cases showed irregular and ill-defined breast masses and 11 cases showed that the long axis of the mass was parallel to the skin (Figure 1A and B and D). There were no posterior features in 8 cases (Figure 1D) and posterior enhancement in 2 cases. Four cases of metastases from lung adenocarcinoma had posterior shadowing or combined pattern (Figure 1E and F). Vascularity was found in 5 cases, including internal blood flow signals in 2 cases, vessels in rim in 1 case, and 2 cases with internal blood flow and vessels in rim (Figure 1B). Nine masses were detected with no vascularity on color doppler examination (Figure 1F). Affected side or bilateral abnormal axillary lymph node could be detected in 5 patients (Figure 1C).
Metastases from pulmonary adenocarcinoma (A and C, H&E 200X) and thyroid transcription factor 1 (B and D, Immunostain 200X). Metastasis from gastric adenocarcinoma (E, H&E 200X) and CDX2 (F, Immunostain 200X).
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Nine cases were TTF-1 positive and 1 case was negative in the cases of breast metastasis from lung cancer (Figure 2A-D). CA125 were positive in patients with ovarian metastasis. CDX2 was positive in two cases of primary gastric origin (Figure 2E and F).