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Significance of intracytoplasmic lumina in the differential diagnosis between epithelial hyperplasia and carcinoma in situ of the breast

The presence of many intracytoplasmic lumina (ICLs) in large papillary breast lesions that could not be easily classified as either papillomas or papillary carcinomas prompted a search for the presence of ICL in the cells of epithelial hyperplasias, papillary tumors, and carcinomas in situ of the breast. Ninety-three cases, i.e., 39 epithelial hyperplasias, 21 papillomas, 8 papillomas with malignant transformation, and 25 carcinomas in situ, were examined after staining with haematoxylin-eosin, Alcian blue (pH 2.5), and Mayer's mucicarmine, with a X 25 objective. In 20 of 21 papillomas (95.2%), ICLs were absent or rare. In 25 of 39 epithelial hyperplasias (64.2%), ICLs were not found. In the remaining 14 cases (35.8%), there were one or two small ICLs per optic field. In all 8 papillomas with malignant transformation, many large ICLs were found. Finally in 17 of 25 cases of carcinoma in situ (68%), there were three or four large ICLs per optic field. In conclusion, the presence of large ICLs may be helpful when taken into account, together with other cytologic and morphologic criteria, in the differential diagnosis between epithelial hyperplasia and carcinoma in situ of the breast.