case_images: PMC8597372_01
case_images: (A) MRI scan identified the tumor as a 46/42 mm nodule, with a polycyclic outline and irregular internal perimeter; (B) CT scan shows a necrotic lobular tumor of 40-50 mm, in the inferior external quadrant of the left breast. CT: Computed tomography; MRI: Magnetic resonance imaging
case_images: RJME-62-1-301-fig1.jpg
case_images: PMC8597372_01_RJME-62-1-301-fig1.jpg
case_images: F1
case_images: On MRI scan, the left side axillary lymph nodes (Figure 1A) did not exceed 9 mm in diameter. The thoracic computed tomography (CT) scan showed a 40-50 mm necrotic lobular tumor, which developed in the left breast's inferior external quadrant, with axillary lymph nodes (Figure 1B).
case_images: Histology of the left breast specimen: (A) Transition between the well-differentiated component and the dedifferentiated component; (B) Dense cellular areas with focal storiform pattern (right) and low cellular area (left). Hematoxylin-Eosin (HE) staining: (A) x100; (B) x40
case_images: RJME-62-1-301-fig2.jpg
case_images: PMC8597372_01_RJME-62-1-301-fig2.jpg
case_images: F2
case_images: There was necrosis in less than 50% of the tumor volume (Figure 2, A and B).
case_images: Immunohistochemical analysis of the left breast demonstrated: (A) Vessel walls within tumor decorated with CD34 - neoplastic cells are CD34 negative (x40); (B) S100 negative in neoplastic cells (x100); (C) Focal positivity for alpha-SMA in neoplastic cells (x100); (D) High Ki67 mitotic index (x100). alpha-SMA: Alpha-smooth muscle actin; CD34: Cluster of differentiation 34
case_images: RJME-62-1-301-fig3.jpg
case_images: PMC8597372_01_RJME-62-1-301-fig3.jpg
case_images: F3