Summary

A 60-year-old woman with end-stage fibrosing interstitial lung disease (ILD) underwent bilateral lung transplantation. Systematic histological analysis of the explanted lungs revealed extensive lymphangitic carcinomatosis and hilar lymph node metastases from a previously undiagnosed breast carcinoma. Retrospective imaging review identified a suspicious mammographic finding that had not been further investigated. The patient was later diagnosed with metastatic breast cancer and passed away at 12 months post-transplant.

This case emphasizes the challenging diagnosis of neoplasia in end-stage lung disease.

The incidence of malignancies in explanted lungs is approximately 1.65%, with metastatic cases being extremely rare.

This report underscores the importance of thorough histopathological evaluation of explant lungs, advocating for standardized examination protocols to improve the accuracy and depth pathological diagnosis.

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Authors

Giuseppe Maggioni - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Omar El Mnif - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Eleonora Faccioli - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Monica Loy - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Francesca Lunardi - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Marco Schiavon - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

Fiorella Calabrese - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

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Copyright

Copyright (c) 2026 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Maggioni, G., El Mnif, O., Faccioli, E., Loy, M., Lunardi, F., Schiavon, M., & Calabrese, F. (2026). Lymphangitic breast cancer in explanted lungs with interstitial lung disease: an unexpected finding. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 118(2). https://doi.org/10.32074/1591-951X-1823
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