Secretory breast carcinoma with metastatic sentinel lymph node

BACKGROUND: Secretory mammary carcinoma is a rare breast neoplasia originally described in children but sometimes also found in adults. It presents a more favourable outcome than more common histological types of breast carcinoma; published literature in fact reports only a few cases with axillary lymph node metastases and only four cases with distant metastases. CLINICAL PRESENTATION: In this paper we report a rare case of secretory breast carcinoma with axillary lymph node metastases in a 33-year-old woman. To our knowledge, this is the first case of secretory carcinoma involving biopsy of the sentinel lymph node and investigation of the e-cadherin expression. We found positivity for e-cadherin, which would support the hypothesis that this type of tumour is a variant of the infiltrating ductal carcinoma. CONCLUSION: After a careful analysis of reported data, we have come to the conclusion that the treatment of choice for patients with secretory breast carcinoma should be conservative surgery with sentinel lymph node biopsy, followed by accurate follow-up. We are of the opinion that while post-operative radiotherapy is indicated in adult patients who have undergone quadrantectomy, it should not be used in children. Although several cases of secretory carcinoma have been treated with adjuvant chemotherapy, there are still no reliable data regarding the real value of such a choice

Evidence for a third, Ir -associated histocompatibility region in the H-2 complex of the mouse

Skin grafts transplanted from B10.HTT donors onto (A.TL × B10)F 1 recipients are rapidly rejected despite the fact that the B10.HTT and A.TL strains should be carrying the same H-2 chromosomes and that both the donor and the recipient contain the B10 genome. The rejection is accompanied by a production of cytotoxic antibodies against antigens controlled by the Ir region of the H-2 complex. These unexpected findings are interpreted as evidence for a third histocompatibility locus in the H-2 complex, H-2I , located in the Ir region close to H-2K . The B10.HTT and A.TL strains are postulated to differ at this hypothetical locus, and the difference between the two strains is explained as resulting from a crossing over between the H-2 t1 and H-2 s chromosomes in the early history of the B10.HTT strain. The H-2 genotypes of the B10.HTT and A.TL strains are assumed to be H-2K s Ir s / k Ss k H-2D d and H-2K s Ir k Ss k H-2D d , respectively. Thus, the H-2 chromosomes of the two strains differ only in a portion of the Ir region, including the H-2I locus. The B10.HTT( H-2 tt ) and B10.S(7R)( H-2 th ) strains differ in a relatively minor histocompatibility locus, possibly residing in the Tla region outside of the H-2 complex.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46727/1/251_2005_Article_BF01564045.pd