Clinical presentation

32-year-old man with 4.5 cm palpable left axillary mass

CT scan

Multiple bilateral lung nodules

Massive left axillary adenopathy

Bilateral hilar and mediastinal adenopathy

Subcentimeter nodule in the right breast

Immunostains

Positive for MOC-31, AE1/3, and E-cadherin

Weak positive for CK20, GATA-3, and ER

Negative for CK7, CK5, CK 34βE12, p63, CDX2, TTF1, Napsin-A, S-100 protein, LCA (CD45), CD3, CD20, synaptophysin, chromogranin, PAX-8, NKX3.1, HER2/neu, and PR

Flow cytometry

Negative for lymphoproliferative disorders

Molecular testing

Positive for EWSR1 gene rearrangement