Abstract
A 71-year-old woman had undergone breast-conserving therapy for breast cancer twelve years prior to the current presentation. Histological examination had revealed invasive ductal carcinoma (pT2NXM0). Twelve years after the operation, she was suspected to have supraclavicular lymph node metastasis because of abnormal accumulation at this site on PET-CT. Ultrasonography showed several round 14 mm hypoechoic lymph nodes without the hilum in the supraclavicular region, and node metastasis was thus suspected. Fine needle aspiration cytology of the nodes showed no conspicuous malignant cells, but malignancy could not be ruled out. She therefore underwent resection of the supraclavicular lymph nodes.
Pathological examination of the lymph nodes showed no cancer cells, but the granuloma was surrounded by epithelioid cells and multinucleated giant cells, strongly suggestive of tuberculosis. QuantiFERON TB-2G (QFT) was detected by blood examination and tuberculous lymphadenitis was diagnosed. Enlarged lymph nodes suspected of being breast cancer recurrence should be thoroughly investigated before recurrence therapy is initiated.
