Two Cases of Tuberculous Lymphadenitis of the Supraclavicular Lymph Nodes Suspected of being Breast Cancer Metastasis

Abstract

We experienced difficulty in differentiating tuberculous lymphadenitis of the supraclavicular lymph nodes from breast cancer metastasis in two cases.

Case 1 : A 63-year-old woman presented to our hospital with a lump on her left clavicle. Chest computed tomography showed a swelling of the left supraclavicular lymph nodes and a left mammary tumor. We performed a core needle biopsy and ultrasonography of the tumor and lymph nodes, respectively. The patient was diagnosed with left breast cancer (cT1N0M0 cStage I) and tuberculous lymphadenitis via imaging and pathological findings. She started taking anti-tuberculosis drugs for tuberculosis and underwent surgery for breast cancer.

Case 2 : At another hospital, a 77-year-old woman received endocrine therapy for left breast cancer (cT4N3M1(LYM) cStage IV) with right supraclavicular lymph node metastasis. When she was transferred to our hospital during her treatment, we noted a mass in her left breast and swelling of the right supraclavicular lymph node. Since we recognized that she had gradually developed resistance to endocrine therapy and because there were no other metastases, we performed left mastectomy and right supraclavicular lymph node excision. No metastasis was found in the lymph node, and tuberculous lymphadenitis was diagnosed.