A Case of Primary Breast Cancer where Preoperative Lymph Node Evaluation was Difficult Because Tuberculous Lymphadenitis Merged it with a Sentinel Lymph Node

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  • センチネルリンパ節に結核性リンパ節炎を認め術前評価に苦慮した乳癌の1例
  • 症例 センチネルリンパ節に結核性リンパ節炎を認め術前評価に苦慮した乳癌の1例
  • ショウレイ センチネルリンパセツ ニ ケッカクセイ リンパセツエン オ ミトメ ジュツゼン ヒョウカ ニ クリョ シタ ニュウガン ノ 1レイ

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An 83-year-old woman presented with a lump in her left breast. Palpation, mammography, ultrasonography, and magnetic resonance imaging revealed an irregular mass, 23 mm in diameter, in the upper outer quadrant of her left breast, indicating breast cancer. Computed tomography showed an enlarged, potentially metastatic, axillary lymph node, and distant metastases were not accepted. After core needle biopsy, the mass was diagnosed as invasive ductal carcinoma of the breast, and fine needle aspiration cytology for the enlarged axillary lymph node did not show any conspicuous malignancy. Left breast mastectomy and sentinel lymph node biopsy were performed. Hematoxylin and eosin staining of the sentinel lymph node showed epithelioid cells, Langhans-type giant cells, and caseous necrosis, similar to the findings of tuberculosis. Tubercle bacillis were detected on Ziehl-Neelsen staining of the sentinel lymph node, and tuberculous lymphadenitis was diagnosed. The diagnosis of the enlarged lymph node was difficult because of tuberculous lymphadenitis of the sentinel lymph node.

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