Synchronous breast cancer and ipsilateral primary tuberculous lymphadenitis in axillary node
Tuberculous lymphadenitis is the commonest form of extrapulmonary tuberculosis with special affinity for cervical, mediastinal, and axillary lymph-nodes. Whilst both carcinoma of the breast and tuberculosis are common in countries with limited resources, the synchronous presence of breast cancer and ipsilateral tuberculous lymphadenitis, can lead to the overstaging of nodes leading to loss of opportunity for breast conservation. We present a case report in which a young woman presented with breast lump along with axillary nodes. However, after surgical resection, it was found that axillary nodal involvement was solely by tuberculosis.
Keywords: Tuberculous lymphadenitis, Carcinoma breast, Overstaging, Axillary node
Fajdic J, Djurovic D, Gotovac N, Hrgovic Z. Criteria and procedures for breast conserving surgery. Acta Informatica Medica. 2013;21(1):16-9.
Goyal S, Singh P, Goyal S. Primary tuberculous granuloma in axillary lymph node draining breast cancer: a rare coincidence and review of recent literature. Clin Cancer Investig J. 2013;2:266-8.
Babu ED, Tariq N, Aref FA, Vashisht R. Axillary gland involvement in breast carcinoma is not always metastatic: a case report. Int Surg. 2004;89:150-1.
Warthin AS. The coexistence of tuberculosis and carcinoma of the mammary gland. Am J Med Sci. 1899;118:25.4.
Vento S, Lanzafame M. Tuberculosis and cancer: a complex and dangerous liaison. Lancet Oncol. 2011;12:520-2.
Kamboj M, Sepkowitz KA. The risk of tuberculosis in patients with cancer. Clin Infect Dis. 2006;42:1592-5.
Bayle GI. Recherchessur la phthisiepulmonaire. In: Bayle GI, eds. A Book. 1st ed. Paris: Gabon; 1810: 310.
Kaplan MH, Armstrong D, Rosen P. Tuberculosis complicating neoplastic diseases: a review of 201 cases. Cancer. 1974;33:850-8.
Fujii T, Kimura M, Yanagita Y, Koida T, Kuwano H. Tuberculosis of axillary lymph nodes with primary breast cancer. Breast Cancer. 2003;10:175-8.
Chottanapund S, Wongtawatchai P. Tuberculous axillary lymphadenitis coexistence in patient with invasive ductal carcinoma of the breast: a case report. Thai J Surg. 2004;25:121-4.
Miller RE, Solomen PF, West JP. The co-existence of carcinoma and tuberculosis of the breast and axillary lymph nodes. Am J Surg. 1971;121:338-40.
Akbulut S, Sogutcu N, Yagmur Y. Coexistence of breast cancer and tuberculosis in axillary lymph nodes: a case report and literature review. Breast Cancer Res Treat. 2011;130:1037-42.
Stead WW. Pathogenesis of a first episode of chronic pulmonary tuberculosis in man: recrudescence of residuals of the primary infection or exogenous reinfection? Am Rev Respir Dis. 1967;95:729-45.
Brincker H. Sarcoid reactions in malignant tumours. Cancer Treat Rev. 1986;13:147-56.
Gregorie HB Jr, Othersen HB Jr, Moore MP Jr. The significance of sarcoid-like lesions in association with malignant neoplasms. Am J Surg. 1962;104:577-86.
Oberman HA. Invasive carcinoma of the breast with granulomatous response. Am J Clin Pathol. 1987;88:718-21.
Coyne JD. Necrobiotic palisading granulomas associated with breast carcinoma. J Clin Pathol. 2005;58:1290-3.
Bässler R, Birke F. Histopathology of tumor associated sarcoid-like stromal reaction in breast cancer. An analysis of 5 cases with immunohistochemical investigations. Virchows Arch A Pathol Anat Histopathol. 1988;412:231-9.
Munjal K, Jain VK, Agrawal A, Bandi PK. Co-existing tubercular axillary lymphadenitis with carcinoma breast can falsely over stage the disease: Case series. Indian J Tuberc. 2010;57:104-7.
CDC. Tuberculosis (TB), 2014. Available at http://www.cdc.gov/tb/topic/testing/default.htm. Accessed 20 November 2014.