Abstract
Reported is an unusual case of adjacent thoracic lymph nodes demonstrating metastases from two different primary malignancies. A 51 year-old woman with a previous history of bilateral breast cancer underwent a radical gastro-oesophagectomy for adenocarcinoma of the lower third of the oesophagus. The resection specimen demonstrated breast and oesophageal metastases in adjacent thoracic lymph nodes. Mechanisms for this phenomenon, including the known local immune suppression on lymphoid cells by oesophageal carcinoma cells, are discussed.
Highlights
Oesophageal carcinoma cells have been shown to exert a local immune suppression on regional lymphoid cells [1], facilitating the metastatic deposit and survival of cancer cells from a distant malignancy [2]
As far as we know this is the first report of such a phenomenon, and the finding parallels the previously reported 'collision phenomenon' in which two distinct primary carcinomas metastasise to the same lymph node
Two paraoesophageal lymph nodes contained adenocarcinoma with appearances compatible with metastases from the oesophageal primary, and which on immunohistochemistry were positive for the epithelial marker cytokeratin 7 (CK7) but negative for oestrogen receptor [Figure 1] and gross cystic disease fluid protein-15 (GCDFP-15), both of which are breast carcinoma related molecules
Summary
Oesophageal carcinoma cells have been shown to exert a local immune suppression on regional lymphoid cells [1], facilitating the metastatic deposit and survival of cancer cells from a distant malignancy [2]. A 51 year-old woman was diagnosed with adenocarcinoma of the distal third of the oesophagus after presenting with dysphagia She had a past history of recurrent bilateral breast cancer necessitating bilateral mastectomy and several courses of radiotherapy to both breasts as well as the left axilla and left chest wall. Two paraoesophageal lymph nodes contained adenocarcinoma with appearances compatible with metastases from the oesophageal primary, and which on immunohistochemistry were positive for the epithelial marker cytokeratin 7 (CK7) but negative for oestrogen receptor [Figure 1] and gross cystic disease fluid protein-15 (GCDFP-15), both of which are breast carcinoma related molecules. Adjacent lymph nodes contained carcinoma compatible with metastatic ductal carcinoma of breast origin [Figure 2] These expressed oestrogen receptors [Figure 3] and gross cystic disease fluid protein-15 (GCDFP-15). Several lymph nodes not involved by tumour demonstrated a silicone-associated reaction [Figure 4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
