Figure 3. Pathological analysis ; (a, b, c, d, e, f, g, h). (3a:【H-Estain, x200】, 3b:【H-Estain, x400】, 3c:【H-Estain, x400】) , 3d:【cytokeratin AE1/3, x200】, 3e:【E-cadherin , x200】, 3f: 【S-100, x200】, 3g:【HMB-45,x200】, 3h:【Berlin Blue, x400】). Right CNB results: malignant melanoma. Cells with atypical nuclei showing an eccentric tendency infiltrated and proliferated trabecularly and sporadically, accompanied by tissue necrosis. Immunostaining showed that the atypical cells were cytokeratin AE1/3 (−) and E-cadherin (−). Due to negativity for cytokeratin, the possibility of a tumor other than carcinoma (e.g., lymphoma) should also be included in the differential diagnosis. Additional immunostaining results showed that the tumor cells exhibited S-100 positivity (S-100, x200), and HMB-45 positivity (HMB-45, x200). The tumor cells completely exhibited negativity for all types of cytokeratin, and negativity for lymphocyte markers. In addition, brown pigment retention was observed in and between tumor cells, which was considered to be melanin pigment due to negativity for iron staining. Based on these findings, it was considered malignant melanoma. Immunostaining results are summarized as follows: AE1/3 (−), CAM5.2 (−), cytokeratin 7 (−), 34βE12 (−), E-cadherin (−), CD3 (−), CD20 (−), CD30 (−), CD68 (−), CD138 (−), S-100 (+), HMB-45 (+). Metastasis from other sites was considered more likely than primary malignancy of the breast

From

A Case of Rare Metastatic Malignant Melanoma of the Breast Parenchyma Diagnosed By Preoperative Core Needle Biopsy: A Case Report

Keiichi Takahashi

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