Pleomorphic invasive lobular carcinoma of the breast mimicking chronic abscess: a case report

Authors

  • Neeharika Phukan Department of Pathology, NIMS Medical College, Jaipur, Rajasthan, India https://orcid.org/0009-0001-2377-2770
  • Sima Chauhan Department of Pathology, NIMS Medical College, Jaipur, Rajasthan, India
  • Natasha Modi Department of Pathology, NIMS Medical College, Jaipur, Rajasthan, India
  • Kinjal Patel Department of Pathology, NIMS Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263127

Keywords:

Pleomorphic lobular carcinoma, Invasive lobular carcinoma, FNAC, Axillary metastasis, Abscess mimic

Abstract

Pleomorphic invasive lobular carcinoma (PLC) is a rare and aggressive subtype of invasive lobular carcinoma that can present with atypical clinical features, often resembling benign inflammatory conditions. A 36-year-old female presented at NIMS hospital, Jaipur, Rajasthan with diffuse swelling of the left breast, clinically suspected to be a chronic abscess. Imaging revealed an ill-defined lesion involving the entire breast. FNAC suggested malignancy. Modified radical mastectomy was performed. Histopathology confirmed pleomorphic invasive lobular carcinoma with extensive lymphovascular and perineural invasion and metastases in all 22 axillary lymph nodes. Immunohistochemistry showed Luminal B molecular subtype. PLC is an aggressive tumor that may mimic benign conditions, leading to diagnostic delay. Accurate diagnosis requires clinicoradiologic correlation and histopathological confirmation with immunohistochemistry.

References

WHO Classification of Tumours Editorial Board. Breast tumours. 5th ed. Lyon: International Agency for Research on Cancer; 2019.

Pestalozzi BC, Zahrieh D, Mallon E, Gusterson BA, Price KN, Gelber RD, et al. Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: combined results of 15 International Breast Cancer Study Group clinical trials. J Clin Oncol. 2008;26(18):3006-14.

Eusebi V, Magalhães F, Azzopardi JG. Pleomorphic lobular carcinoma of the breast: an aggressive tumour showing apocrine differentiation. Hum Pathol. 1992;23(6):655-62.

Middleton LP, Palacios DM, Bryant BR, Krebs P, Otis CN, Merino MJ. Pleomorphic lobular carcinoma: morphology, immunohistochemistry, and molecular analysis. Am J Surg Pathol. 2000;24(12):1650-1656.

Silver SA, Tavassoli FA. Pleomorphic carcinoma of the breast: clinicopathological analysis of 26 cases of an unusual high-grade phenotype of ductal carcinoma. Histopathology. 2000;36(6):505-14.

Palacios J, Sarrió D, García-Macias MC, Bryant B, Sobel ME, Merino MJ. Frequent E-cadherin gene inactivation by loss of heterozygosity in pleomorphic lobular carcinoma of the breast. Mod Pathol. 2003;16(7):674-78.

Zhao J, Lang R, Guo X, Chen L, Gu F, Fan Y, et al. Clinicopathologic characteristics of pleomorphic carcinoma of the breast. Virchows Arch. 2010;456(1):31-37.

Günhan-Bilgen I, Ustün EE, Memiş A. Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases. Radiology. 2002;223(3):829-38.

Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline focused update. J Clin Oncol. 2018;36(20):2105-22.

Nguyen CV, Falcón-Escobedo R, Hunt KK, Nayeemuddin KM, Lester TR, Harrell RK, et al. Pleomorphic ductal carcinoma of the breast: predictors of decreased overall survival. Am J Surg Pathol. 2010;34(4):486-93.

Kini H, Pai RR, Rau AR, Lobo FD, Augustine AJ, Ramesh BS. Pleomorphic lobular carcinoma of the breast: a diagnostic dilemma. J Cytol. 2007;24(4):193-95.

Robinson IA, McKee G, Jackson PA, Cook MG, Kissin MW. Lobular carcinoma of the breast: cytological features supporting the diagnosis of lobular cancer. Diagn Cytopathol. 1995;13(3):196-201.

Rakha EA, Ellis IO. Lobular breast carcinoma and its variants. Semin Diagn Pathol. 2010;27(1):49-61.

Wahed A, Connelly J, Reese T. E-cadherin expression in pleomorphic lobular carcinoma: an aid to differentiation from ductal carcinoma. Ann Diagn Pathol. 2002;6(6):349-351.Romero R, Kalache KD, Kada N. Timing the delivery of the preterm severely growth restricted fetus: venous Doppler, cardiotocography on the biophysical profile? Ultrasound Obstet Gynacol. 2002;19: 118-21.

Downloads

Published

2026-08-29

How to Cite

Phukan, N., Chauhan, S., Modi, N., & Patel, K. (2026). Pleomorphic invasive lobular carcinoma of the breast mimicking chronic abscess: a case report . International Journal of Research in Medical Sciences, 14(9), 4053–4057. https://doi.org/10.18203/2320-6012.ijrms20263127

Issue

Section

Case Reports