%0 Journal Article
%T Anatomo-Clinical Case: Coexistence of Tuberculosis with Axillary Lymph Node Metastasis in Breast Carcinoma
%A Aim¨¦ Sosth¨¨ne Ou¨¦draogo
%A Hierrhum Aboubacar Bambara
%A Franck Auguste Hermann Ademayali Ido
%A Welbnoaga Norbert Ramd¨¦
%A Rimwaogdo Jeremie Sawadogo
%A Ibrahim Savadogo
%A Souleymane Ouattara
%A Hassami Barry
%A Assita Sanou-Lamien
%A Olga Melanie Lompo
%J Open Journal of Pathology
%P 132-138
%@ 2164-6783
%D 2018
%I Scientific Research Publishing
%R 10.4236/ojpathology.2018.84015
%X Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right breast for one year. The scan and mammography revealed a long-axis node of 3 ¡Á 2 ¡Á 1 cm in the upper outer quadrant of the right breast ranked stage IV by the American College of Radiology (ACR), associated with a set of axillary lymph nodes and the largest one measuring 15 ¡Á 15 ¡Á 20 millimeters (mm). The breast biopsy helped diagnose a Scarff Bloom Richardson (SBR) grade II non-specific invasive carcinoma, modified by Ellis and Elston. A right mastectomy associated with a lymph node dissection was performed. We noticed a not well defined and whitish 5 mm tumor mass associated with 16 lymph nodes removed. The histological examination confirmed the diagnosis of SBR grade II non-specific invasive carcinoma with invasion of 7 lymph nodes (N+ = 7/16). In 3 metastatic lymph nodes, there were epithelioid and gigantocellular granulomas with full central necrosis. The Ziehl Neelsen staining had highlighted acid-fast bacilli. The tumor was oestrogen and progesteron receptor, without an overexpression of the oncoprotein human epidermal growth factor receptor 2 (HER2), which corresponds to a 0 score and the Ki 67 proliferation index assessed at 10%. The patient was given an anti-tuberculosis treatment combining Rifampicin (H), Isoniazid (I), Pyrazinamid (Z), Ethambutol (E) over 2 months and secondly a combination of Rifampicin and Isoniazid over 4 months (2RHZE/4 RH). The anti-tumor chemotherapy used a protocol combining 3 FAC60+ 3 Docetaxel (F = Fluorouracil®; A = Adriblastin®, C = Cyclophosphamid). Conclusion: This coexistence is uncommon, of incidental discovery and necessitates a multidisciplinary care.
%K Breast Carcinoma
%K Tuberculosis
%K Lymph Node
%K Histopathology
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=87470