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Presented by Pedram Argani, M.D. and prepared by Sharon Swierczynski, M.D., Ph.D.
Case 2: A 49-year-old female with mammographic abnormalities
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1. Question
Week 171: Case 2
A 49-year-old female with mammographic abnormalitiesimages/020204case2fig1.jpg
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images/020204case2fig5.jpgCorrect
Answer: Ductal carcinoma in-situ and Lobular carcinoma in-situ
Histology: The majority of this lesion is composed of a uniform population of hyperchromatic ductal cells forming regularly spaced projections (micropapillae) into duct lumens. The cells are monotonous and evenly placed, and extend over an area much larger than 3 mm. Hence, the lesion qualifies for ductal carcinoma in situ. There is also focal necrosis, supporting the diagnosis. Additionally, however, there is a population of dyscohesive smaller cells that undermine existing ductal epithelium. Some of these cells show signet-ring cell cytology. These are the typical features of lobular carcinoma in situ. LCIS merges with the DCIS in several ducts. Adjacent to these ducts are clusters of multinucleated stromal giant cells that mimic invasive carcinoma.
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Incorrect
Answer: Ductal carcinoma in-situ and Lobular carcinoma in-situ
Histology: The majority of this lesion is composed of a uniform population of hyperchromatic ductal cells forming regularly spaced projections (micropapillae) into duct lumens. The cells are monotonous and evenly placed, and extend over an area much larger than 3 mm. Hence, the lesion qualifies for ductal carcinoma in situ. There is also focal necrosis, supporting the diagnosis. Additionally, however, there is a population of dyscohesive smaller cells that undermine existing ductal epithelium. Some of these cells show signet-ring cell cytology. These are the typical features of lobular carcinoma in situ. LCIS merges with the DCIS in several ducts. Adjacent to these ducts are clusters of multinucleated stromal giant cells that mimic invasive carcinoma.
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