PMC3187933_01
Tough lumps of bilateral breasts with inverted nipples. (These photos were taken after the third course of chemotherapy.)
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F1
Finally, her bilateral breasts seemed as hard as stones (Fig. 1).
Abdominal ultrasound detection appeared that lumps in bilateral ovaries with rich blood supply ( ). Fluid sonolucent areas were seen besides ovaries ( ).
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F2
She was transferred to our hospital and re-examined, and the same signs were found under ultrasound (Fig 2).
HE staining and ISH of metastatic SRCC in breast. A-B. The hematoxylin-eosin(H&E) staining revealed that a quantities of signet ring-like cells were diffused among fibrous tissues and several residual breast little ducts and glands were scattered in tumors ( ) (A: H&E x200, B: H&E x400). C-D. AB and PAS staining appealed blue and red positive signal in cytoplasm of signet ring-like cells (x400). E-H. CK20, Villin, CA199 and CDX2 positive expression in ring-like cells (E: Envisionx200, F-H: Envisionx400). I-L. CK7, ER, E-cadherin, CK5/6 negative express in tumor cells and positive in residual breast little ducts and glands (Envisionx200).
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F3
CK7 were positive in breast gland epithelium, and negative in tumor cells. CK20, CA199, CDX2 and Villin were positive in tumor cells (Fig 3), CerbB2 and CA125 negative.
Metastatic SRCC on ovaries and oviducts. A. H&E staining showed that signet ring-like cells were diffused among ovarian stromal tissues (H&Ex200). B. Tumor cells invade serosa of oviduct ( ) (H&Ex200). C-E. CK20, Villin, CDX2 positive expression in SRCC (Envisionx400).
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F4
Interestingly, H&E and IHC of lesions of bilateral ovaries and those nodules in abdomen were all consistent with those of the breast tumors (Fig 4).