case_images: PMC11789902_01
case_images: Ultrasound and histopathological examination of the nodules. (A) Ultrasonography shows a hypoechoic nodule with clear boundaries and an oval shape located in the lower quadrant of the right breast. (B) The nodule was located 0.41 cm from the skin. (C) No significant blood flow was observed within the nodules. (D) The tumor had an intact capsule (hematoxylin and eosin staining, x100). (E) Densely packed spindle cells in the Antoni A area, and a looser Antoni B area (hematoxylin and eosin staining x 100) are shown. (F) Verocay bodies arranged in a palisade pattern are visible in the Antoni A area (hematoxylin and eosin staining x 200).
case_images: medi-104-e41309-g001.jpg
case_images: PMC11789902_01_medi-104-e41309-g001.jpg
case_images: F1
case_images: Laboratory test results were normal; however, ultrasonography revealed an oval hypoechoic nodule in the lower quadrant of the right breast measuring 0.86 cm x 0.64 cm and located 0.41 cm beneath the skin surface (Fig. 1A, B). The nodule exhibited clear boundaries and uniform internal echogenicity with no signs of significant blood flow on color Doppler flow imaging (Fig. 1C). Low-magnification microscopy revealed a tumor with an intact capsule (Fig. 1D), primarily consisting of Antoni A areas, and the periphery mostly consisting of Antoni B areas (Fig. 1E). Antoni A areas. Additionally, characteristic Verocay bodies comprising 2 parallel rows of tightly arranged nuclei with intervening eosinophilic cytoplasm were scattered throughout the Antoni A area (Fig. 1F).
case_images: Immunohistochemical analysis. (A) Tumor cells with diffuse and strong positive staining for S-100 (IHC; x100) are shown. (B) Tumor cells with diffuse and strong positive staining for SOX10 (IHC; x100) are shown. (C) Less than 2% of the tumor cells were positive for Ki67 (IHC; x100). (D-L) Tumor cells were negative for the following proteins: CKpan (D), P63 (E), CK5/6 (F), C-erB-2 (G), CD117 (H), DOG1 (I), SMA (J), Desmin (K), and Syn (L) (IHC; x100). IHC = immunohistochemistry, SMA = smooth muscle actin, Syn = synaptophysin.
case_images: medi-104-e41309-g002.jpg
case_images: PMC11789902_01_medi-104-e41309-g002.jpg
case_images: F2
case_images: Immunohistochemical analysis revealed a strong diffuse positivity for S-100 (Fig. 2A), and SOX10 (Fig. 2B) with a Ki67 index <2% (Fig. 2C). The tumor cells were negative for CKpan, P63, CK5/6, C-erB-2, CD117, DOG-1, smooth muscle actin (SMA), Desmin, and synaptophysin (Fig. 2D-L).