Sarcoidosis is a multisystem, inflammatory granulomatous disease that rarely involves breast tissue. The pathophysiology of this chronic granulomatous condition is not well understood but is thought to be multifactorial, involving environmental influences causing an amplified immune response. A key histomorphology feature in sarcoidosis is the presence of non-necrotizing granulomas. In this case, we report a 41-year-old African-American man with a known history of sarcoidosis of the lung who presented with gynecomastia and bilateral breast tenderness with palpable nodules. Subsequent biopsy and microscopic examination of the breast nodules revealed diffuse involvement with non-necrotizing granulomas in both breasts. A final diagnosis of extensive sarcoidosis involving breast tissue was rendered after excluding other causes of non-necrotizing granulomas. The patient underwent a bilateral mastectomy to remove the breast nodules. This case discusses sarcoidosis involving an unusual site.

Carcinoma da mama com apresentação bilateral é uma doença pouco avaliada na literatura, com raros trabalhos científicos que comparam os aspectos moleculares de ambos os tumores. No presente estudo, analisamos os tumores de 45 pacientes portadoras de carcinoma ductal invasivo bilateral em relação às expressões de claudinas-4 e 7, de E-caderina e de -catenina por meio de imunoistoquímica em TMA. Além desses marcadores, analisamos o estado dos receptores de estrógeno e de progesterona, bem como diversas características histopatológicas (grau histológico, nuclear, mitose, infiltrado, desmoplasia e necrose). A amostra foi caracterizado por média de idade de 52,4 anos e os tumores foram divididos em mama primário (MP) e mama secundário (MS). Não houve diferenças entre os dois grupos (MP e MS) nos marcadores testados, sendo que a expressão foi coincidente nas seguintes proporções: claudina-4 (83,8%, p=0,61), claudina-7 (82,2%, p=0,29), E-caderina (81%, p=0,48), -catenina (89,7%, p=0,48), receptor de estrogeno (66%, p=0.75) e receptor de progesterona (55%, p=0.99). Em relação aos aspectos morfológicos, grau histológico (SBR) II, infiltrado inflamatório discreto, necrose, desmoplasia moderada e índice mitótico (<10fm/10cga) foram coincidentes em 57,8%, 60%, 55,6%, 63,6% e 55,6%, respectivamente. Os presentes resultados nos permitem inferir que os tumores de apresentação bilateral são, em sua maioria, similares do ponto de vista morfológico e da expressão dos marcadores testados / Forty-five patients with invasive ductal carcinoma were evaluated for the expression of claudin-4, claudin-7, E-cadherin, and -catenin through tissue microarray (TMA) and immunohistochemistry (IHC) analysis. Besides these markers, estrogen (ER) and progesterone receptor (PR) status was analyzed, in addition to histopathologic characteristics, i.e., histologic grade, nuclear, mitoses, infiltrate, desmoplasia, and necrosis. Tumors were divided into primary breast (PB) and secondary breast (SB). The expression of claudin-4 and -7 was coincident in PB and SB in 83.78% and 82.22% respectively. The expression of -catenin and E-cadherin in PB and SB was coincident in 89.74% and 80.95% respectively. Estrogen receptor status was (+) in both breasts in 66%, while progesterone receptor status (+) was in 55%. The histological grade using the Nottingham-modified Scarff-Bloom-Richardson grading system (MSBR) showed mild infiltrate, necrosis (+), moderate desmoplasia and mitotic index (<10) was coincident in 57.77%, 60.00%, 55.55%, 63.63% and 55.55% respectively. The degree of agreement showed claudin-4 (p=0.61), claudin-7 (p=0.29), E-cadherin (p=0.48), and -catenin (p=0.48). The expression of claudin-4 and -7, E-cadherin and -catenin present a strong agreement between tumors, showing that bilateral tumors are not different. Histopathologic characteristics showed a lesser agreement between tumors

Carcinoma da mama com apresentação bilateral é uma doença pouco avaliada na literatura, com raros trabalhos científicos que comparam os aspectos moleculares de ambos os tumores. No presente estudo, analisamos os tumores de 45 pacientes portadoras de carcinoma ductal invasivo bilateral em relação às expressões de claudinas-4 e 7, de E-caderina e de -catenina por meio de imunoistoquímica em TMA. Além desses marcadores, analisamos o estado dos receptores de estrógeno e de progesterona, bem como diversas características histopatológicas (grau histológico, nuclear, mitose, infiltrado, desmoplasia e necrose). A amostra foi caracterizado por média de idade de 52,4 anos e os tumores foram divididos em mama primário (MP) e mama secundário (MS). Não houve diferenças entre os dois grupos (MP e MS) nos marcadores testados, sendo que a expressão foi coincidente nas seguintes proporções: claudina-4 (83,8%, p=0,61), claudina-7 (82,2%, p=0,29), E-caderina (81%, p=0,48), -catenina (89,7%, p=0,48), receptor de estrogeno (66%, p=0.75) e receptor de progesterona (55%, p=0.99). Em relação aos aspectos morfológicos, grau histológico (SBR) II, infiltrado inflamatório discreto, necrose, desmoplasia moderada e índice mitótico (<10fm/10cga) foram coincidentes em 57,8%, 60%, 55,6%, 63,6% e 55,6%, respectivamente. Os presentes resultados nos permitem inferir que os tumores de apresentação bilateral são, em sua maioria, similares do ponto de vista morfológico e da expressão dos marcadores testados / Forty-five patients with invasive ductal carcinoma were evaluated for the expression of claudin-4, claudin-7, E-cadherin, and -catenin through tissue microarray (TMA) and immunohistochemistry (IHC) analysis. Besides these markers, estrogen (ER) and progesterone receptor (PR) status was analyzed, in addition to histopathologic characteristics, i.e., histologic grade, nuclear, mitoses, infiltrate, desmoplasia, and necrosis. Tumors were divided into primary breast (PB) and secondary breast (SB). The expression of claudin-4 and -7 was coincident in PB and SB in 83.78% and 82.22% respectively. The expression of -catenin and E-cadherin in PB and SB was coincident in 89.74% and 80.95% respectively. Estrogen receptor status was (+) in both breasts in 66%, while progesterone receptor status (+) was in 55%. The histological grade using the Nottingham-modified Scarff-Bloom-Richardson grading system (MSBR) showed mild infiltrate, necrosis (+), moderate desmoplasia and mitotic index (<10) was coincident in 57.77%, 60.00%, 55.55%, 63.63% and 55.55% respectively. The degree of agreement showed claudin-4 (p=0.61), claudin-7 (p=0.29), E-cadherin (p=0.48), and -catenin (p=0.48). The expression of claudin-4 and -7, E-cadherin and -catenin present a strong agreement between tumors, showing that bilateral tumors are not different. Histopathologic characteristics showed a lesser agreement between tumors