Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Pedram Argani, M.D. and prepared by Jeffrey T. Schowinsky, M.D.
Case 1: A 69 year old female with a 10 cm breast mass.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 302: Case 1
A 69 year old female with a 10 cm breast mass.images/022607PA1a.jpg
images/022607PA1b.jpg
images/022607PA1c.jpg
images/022607PA1d.jpg
images/022607PA1e.jpgCorrect
Answer: Metaplastic carcinoma, high grade
Histology: This is a high grade malignant neoplasm featuring broad areas of necrosis, pleomorphic tumor cells, and abnormal mitoses. The majority of the tumor consists of spindled cells with elongated nuclei, simulating a sarcoma. However, adjacent to this invasive neoplasm are foci of high grade ductal carcinoma in situ, and other areas of conventional high grade invasive ductal carcinoma. The latter two findings are sufficient to classify this neoplasm as a sarcomatoid carcinoma (metaplastic carcinoma).
The carcinoma cells stained positive for cytokeratin AE1/AE3 (pictured below).
Discussion: A sarcoma would lack the foci of in situ or invasive carcinoma identified within this lesion. A phyllodes tumor should show at least focal evidence of an exaggerated intracanalicular pattern, and would lack the epithelial component of this lesion. Malignant melanoma is classically both spindled and epithelioid, but would not grow within the existing ducts.
Incorrect
Answer: Metaplastic carcinoma, high grade
Histology: This is a high grade malignant neoplasm featuring broad areas of necrosis, pleomorphic tumor cells, and abnormal mitoses. The majority of the tumor consists of spindled cells with elongated nuclei, simulating a sarcoma. However, adjacent to this invasive neoplasm are foci of high grade ductal carcinoma in situ, and other areas of conventional high grade invasive ductal carcinoma. The latter two findings are sufficient to classify this neoplasm as a sarcomatoid carcinoma (metaplastic carcinoma).
The carcinoma cells stained positive for cytokeratin AE1/AE3 (pictured below).
Discussion: A sarcoma would lack the foci of in situ or invasive carcinoma identified within this lesion. A phyllodes tumor should show at least focal evidence of an exaggerated intracanalicular pattern, and would lack the epithelial component of this lesion. Malignant melanoma is classically both spindled and epithelioid, but would not grow within the existing ducts.
