case_images: PMC9881483_01
case_images: Pathology slides from a breast biopsy. (a) Micro calculi in a ductal pattern from left breast tissue. (b) Stromal sclerosis and infiltrating lobular cancer from left breast tissue. (c) Cells in a single file line, indicating lobular carcinoma from left breast tissue.
case_images: jmc-14-013-g001.jpg
case_images: PMC9881483_01_jmc-14-013-g001.jpg
case_images: F1
case_images: Pathology revealed estrogen-positive, progesterone-positive, HER-2 negative invasive lobular carcinoma (Fig. 1) of the left breast and ductal carcinoma in situ of the right breast.
case_images: T1-weighted MRI image of the brain. Mild to moderate hydrocephalus (white arrow). T2 hyperintensity consistent with transependymal spread of CSF (red arrow). There is no evidence of mass. There is no abnormal gadolinium enhancement. CSF: cerebrospinal fluid; MRI: magnetic resonance imaging.
case_images: jmc-14-013-g002.jpg
case_images: PMC9881483_01_jmc-14-013-g002.jpg
case_images: F2
case_images: Repeat CT of head showed interval improvement of the mild hydrocephalus, and MRI (Fig. 2) of the cervical and thoracic spine did not demonstrate any metastatic lesions.
case_images: Pathology slides form the cerebrospinal fluid. (a) Enlarged nucleoli with cytoplasmic vacuoles on cerebrospinal fluid cytology (May Grunwald-Giemsa stain). (b) Wright stain indicating a nest of tumors with increased cytoplasm, non-spindled from cerebrospinal fluid cytology.
case_images: jmc-14-013-g003.jpg
case_images: PMC9881483_01_jmc-14-013-g003.jpg
case_images: F3
case_images: CSF studies from lumbar drain revealed small groups of large vacuolated epithelial cells having circular nuclei with distinct nucleoli consistent with metastatic mammary adenocarcinoma (Fig. 3).