Two rare cases of endosalpingiosis in the axillary sentinel lymph nodes: evaluation of immunohistochemical staining and one-step nucleic acid amplification (OSNA) assay in patients with breast cancer

  • Sho Shiino
  • Masayuki YoshidaEmail author
  • Kenjiro Jimbo
  • Sota Asaga
  • Shin Takayama
  • Akiko Maeshima
  • Hitoshi Tsuda
  • Takayuki Kinoshita
  • Nobuyoshi Hiraoka
Brief Report


Benign inclusions, such as endosalpingiosis, in an axillary sentinel lymph node (SLN) can be misdiagnosed as metastatic breast carcinoma. However, endosalpingiosis is rare in lymph nodes above the diaphragm. Among 792 patients with breast carcinoma who underwent sentinel lymph node biopsy at our center, 2 patients have experienced benign glandular inclusions in 3 SLNs, and all of these glandular inclusions were lined with columnar and ciliated epithelial cells. Immunohistochemistry revealed that the epithelial cells were positive for Müllerian markers (e.g., PAX8 and WT-1) and negative for mammary markers (e.g., mammaglobin, GCDFP-15, and GATA3), which confirm the diagnosis of endosalpingiosis. The epithelial cells were positive for CK19 but the one-step nucleic acid amplification assay revealed negative results for the axillary SLNs. Although endosalpingiosis is rare in axillary SLNs, care is needed to identify these rare cases and avoid unnecessary axillary lymph node dissection, overstaging, and overtreatment.


Endosalpingiosis Benign glandular inclusion Axillary sentinel lymph node Immunohistochemistry OSNA assay 


Author contributions

SS and MY designed the study researched and analyzed the data; and wrote, edited, and reviewed the manuscript. HT analyzed the data and reviewed the manuscript. KJ, SA, ST, and TK provided clinical details and reviewed the manuscript. AM and NH provided pathological information and reviewed the manuscript. All authors gave final approval for publication.

Compliance with ethical standards

This study was approved by the Ethics Committee of the National Cancer Center Hospital, Tokyo, Japan.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sho Shiino
    • 1
    • 2
  • Masayuki Yoshida
    • 3
    Email author
  • Kenjiro Jimbo
    • 1
  • Sota Asaga
    • 1
  • Shin Takayama
    • 1
  • Akiko Maeshima
    • 3
  • Hitoshi Tsuda
    • 4
  • Takayuki Kinoshita
    • 1
  • Nobuyoshi Hiraoka
    • 3
  1. 1.Department of Breast SurgeryNational Cancer Center HospitalTokyoJapan
  2. 2.Graduate School of MedicineKeio University School of MedicineTokyoJapan
  3. 3.Department of Pathology and Clinical LaboratoriesNational Cancer Center HospitalTokyoJapan
  4. 4.Department of Basic PathologyNational Defense Medical CollegeTokorozawaJapan

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