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Difference between revisions of "Talk:Non-invasive breast carcinoma"
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Talk:Non-invasive breast carcinoma (view source)
Revision as of 13:28, 18 August 2011
, 13:28, 18 August 2011→DCIS in papillary lesion, DCIS: new section
m (moved Talk:Non-invasive breast cancer to Talk:Non-invasive breast carcinoma: more accurate) |
(→DCIS in papillary lesion, DCIS: new section) |
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Ductal carcinoma in situ (cribriform and solid pattern), Grade 1/3.<br> | Ductal carcinoma in situ (cribriform and solid pattern), Grade 1/3.<br> | ||
No necrosis identified.<br> | No necrosis identified.<br> | ||
== DCIS in papillary lesion, DCIS == | |||
===Microscopic=== | |||
The specimen consists of left breast mastectomy and sentinel node excision, for a large complex partially cystic subareolar mass that distorts and elevates the nipple–areola complex. | |||
Part A.<br> | |||
The sections show a circumscribed lesion with fibrovascular cores (papillary lesion). There is epithelial proliferation with cells that have moderate nuclear enlargement, irregular chromatin with focal clearing, and nucleoli (seen with the 10x objective). There is low mitotic activity (2 mitoses / 10 HPF, 1 HPF = 0.2376 mm^2). The epithelial cells have a cribriform architecture and focally form a sheet. There is no necrosis in the papillary lesion. | |||
In the surround breast there are large atypical hypercellular glands with necrosis and atypical cohesive cells with nuclear atypia. The glands are well circumscribed and basal cells are discernible in many. No stromal desmoplasia is identified. | |||
Three morphologically benign lymph nodes are present, in which no carcinoma was identified. There is cystic glandular dilation (fibrocystic change) and focal columnar cell morphology in the epithelial component without atypia and hyperplasia (columnar cell change). | |||
Focally, the skin has a prominent granular layer and invaginates into a space containing abundant keratinous debris (block A). | |||
There is an intraductal paucicellular fibrotic mass composed of bland spindle cells (probable sclerosed papilloma). | |||
Immunostaining with p63 and SMMS was done on several blocks and showed preservation of the myoepithelial layer. | |||
<br> | |||
Part B.<br> | |||
The sections show morphologically benign lymph nodes with a non-specific sinus histiocytosis. There is no macrophage nuclear enlargement. Emperipolesis is not identified. No tumour cells are identified. | |||
No morphologically concerning keratin staining cells were identified. | |||
===Final diagnosis=== | |||
1. Left breast, mastectomy:<br> | |||
Papilloma with ductal carcinoma in situ, Architecture: cribiform and solid, Grade 2/3.<br> | |||
Ductal carcinoma in situ, Architecture: cribiform (with necrosis) and solid, Grade 3/3.<br> | |||
No invasive carcinoma is identified.<br> | |||
Three lymph nodes negative for malignancy (0 / 3).<br> | |||
Fibrocystic change.<br> | |||
Columnar cell change.<br> | |||
Epidermal inclusion cyst.<br> | |||
Sclerosed papilloma. | |||
2. Sentinel node excision:<br> | |||
Seven lymph nodes negative for malignancy (0 / 7). | |||