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Extramedullary Hematopoiesis in Breast after Neoadjuvant Chemotherapy for Breast Carcinoma

Address correspondence to Farbod Darvishian, M.D., Department of Pathology, New York University Medical Center, 530 First Avenue, SK10U, New York, NY 10016, USA; tel 212 263 0138; fax 212 263 5509; e-mail: farbod. darvishian{at}nyumc.org; farbodarv{at}yahoo.com.

We report incidental extramedullary hematopoiesis (EMH) in breasts of 2 patients following neoadjuvant chemotherapy for locally advanced breast cancer. Neither of the patients had a history of hematologic disorders. After chemotherapy, one of the patients had a complete pathologic response and the other had residual carcinoma. In both cases, EMH was mostly seen as myelopoiesis in a background of chemotherapy-induced changes. In the patient with residual carcinoma, EMH was observed in the contralateral prophylactic mastectomy specimen. EMH should be considered a diagnostic pitfall in the differential diagnosis of unusual cellular infiltrates in breast after neoadjuvant chemotherapy. To our knowledge, the association of EMH and neoadjuvant chemotherapy has not been previously reported.

Keywords: extramedullary hematopoiesis, breast, neoadjuvant chemotherapy