XANTHOMA OF THE BREAST In a series of nine hundred (circa ...

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American Association for Cancer Research.
1090 CUSHMAN D. HAAGENSEN
following month it diminished distinctly in size. In May 1928 excision
was done. Three years later there had been no recurrence.
Gross Diagnosis (Pathologic Specimen No. B 4810); The specimen
consists of a wedge of breast tissue in which there is a well circumscribed
yellowish nodule 0.5 ern. in diameter. Gross diagnosis: Xanthoma.
Microscopic Diagnosis: The tumor is made up of xanthoma cells lying
in a fibrous stroma (Figs. 7 and 8). The cells are between 20 and 40
microns in diameter. The nuclei are relatively small. The foamy cytoplasm
stains very lightly. Scattered foci of lymphocytes are seen.
Diagnosis: Primary xanthoma of the breast.
CASE 3: M. H. L., an Irish widow, aged thirty-eight, came to the
Memorial Hospital, Nov. 10, 1926.
Past History: One sister had had a tumor of the breast. The patient
had had three normal pregnancies and had nursed all three children.
The last lactation was in 1921.
Present Illness: In March 1925, the patient had noticed a lump in
her left breast, and in August 1926 a radical mastectomy was done in a
New York hospital. In November 1926 she came to Memorial Hospital
complaining of dyspnea.
Phusical Examination: Examination showed a group of hard nodes
in the left supraclavicular region. Roentgenograms of the chest were
negative. The scar showed no evidence of recurrence.
Treatment: A diagnosis of carcinoma metastasis was made and treatment
with the radium element pack was given over the supraclavicular
nodes.
In January 1927 a freely movable, hard subcutaneous nodule about
1 cm. in diameter was observed near the edge of the scar, in the anterior
axillary line over the 9th costal cartilage. This was thought to be a
recurrence of carcinoma and was excised under novocaine anesthesia.
At this time the patient was fairly well nourished, although she was
anemic. Several urine examinations were negative for sugar and albumin.
In March 1927 the patient began to have pain in the back. Roentgenograms
taken in April showed widespread metastases in the lumbar
spine, pelvic bones, and upper femora. Death occurred in October
1927.
Gross Diagnosis (Pathologic Specimen No. B 1497): On section of the
nodule excised from the chest wall a small, yellowish, solid, opaque nodule
2 mm. in diameter is seen. It is not adherent to the skin but rests on
the fascia and is freely movable. Gross diagnosis; Xanthoma.
Microscopic Diagnosis: The tumor is a small nodule, surrounded by
fat, and composed wholly of xanthoma cells lying in a fibrous stroma
(Figs. 9 and 10). The cells average 40 microns in diameter and are
irregularly polyhedral in shape. The nuclei are comparatively small, and
stain darkly. The cytoplasm is amphophilic and contains a fine fibrillar
network. There is no lymphocytic infiltration. Carcinoma cells are not
seen.
Diagnosis: Primary xanthoma of chest wall at site of amputated
breast.