PMC9301115_01
H&E stain of the tumor section revealed malignant cells with scanty cytoplasm,
vesicular nuclei with indistinct nucleoli, and mild pleomorphism.
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The obtained sections demonstrated extensive tumor necrosis, with a few minor areas of malignant epithelial cell infiltration (see Figure 1).
(A-F) Immunohistochemistry staining of breast sections for breast-carcinoma related
markers: the staining was negative for cytokeratins (Ck and CK7) (A&B), estrogen
receptor (C), progesterone receptor (D), the transcription factor GATA3 (E), and HER2
(F).
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The obtained results of breast carcinoma-related markers such as cytokeratins (Ck and CK7), the transcription factor GATA3, estrogen receptor (ER), progesterone receptor (PR), HER2, and E-cadherin were negative as shown in Figure 2.
(A-E) Immunohistochemistry staining of breast sections for plasma cells
neoplasia-related markers. The staining was negative for monocyte-lineage related marker
CD68 (A), but positive for plasma cell marker CD138 (B), multiple myeloma oncogene
(MUM1) (C), and kappa-light chain. Whereas, lambda-light chain was negative (D).
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Whereas the staining was positive for each of CD138, MUM1, EMA (focally), P53, and kappa-light chain as showed in Figure 3, which resulted in proposing plasma cell neoplasia. Other markers such as CD68, LCA, CD79a, and lambda-light chain were also shown to be negative (see Figure 3).
(A-B) Evidence of multiple osteolytic bone lesions mainly evident at ribs and the
sternum (the green arrows). The largest lesion at the left lower ribs around 2.5 x 4.8
cm with soft tissue component (A). diffuse osteolytic appearance of whole skeletal
bones, prominently seen at the left iliac bone (B).
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In addition, diffuse osteolytic bone lesions were discovered in the ribs and pelvic bone, primarily at the left iliac bone as illustrated in Figure 4.
T1 fat-saturated post-contrast MRI image revealed multiple enhanced vertebral bodies at
the upper thoracic region, with multiple enhanced destructive osteolytic vertebral body
lesions at the lumbar vertebrae.
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Moreover, MRI results showed that there was multiple increased destructive osteolytic vertebral body lesions at the lumbar vertebrae as well as there was a parenchymal focal lesion in the left lobe of the liver, which was an indication of liver metastasis (see Figures 5 and 6).
CT scan post-contrast image showed left hepatic lobe with small parenchymal focal
lesion, along with peripheral enhancement measuring 1.5 x 1 cm.
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Moreover, MRI results showed that there was multiple increased destructive osteolytic vertebral body lesions at the lumbar vertebrae as well as there was a parenchymal focal lesion in the left lobe of the liver, which was an indication of liver metastasis (see Figures 5 and 6).
PMC9301115_02