PMC5350496_01
A. A right mammogram, cranio-caudal view showing an area of asymmetric density. B. A spot magnification compression view shows an elongated mass with irregular margins and faint calcifications.
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Mammogram showed a fatty breast with an asymmetric density in the right upper outer quadrant with no calcifications (Fig. 1A); spot magnification compression view revealed an ill-defined elongated mass with faint calcifications (Fig. 1B).
A right breast ultrasound showing a hypodense lobulated horizontally oriented lesion (A) with peripheral vascularity (B).
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Right breast ultrasound showed a hypodense lobulated horizontally oriented lesion (Fig. 2A) measuring 1.3 x 0.8 cm with mild increased peripheral vascularity (Fig. 2B).
MRI showed an irregular mass with distortion; it has an irregular enhancement at the margins. Multiple benign looking axillary lymph nodes are seen with preserved fatty hilum.
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Magnetic Resonant Imaging (MRI) of the breast showed an irregularly enhancing lesion with distortion and benign looking axillary lymph nodes (Fig. 3).
A. DCIS of solid type, intermediate grade. Note the clear cytoplasm in the populated cells of the DCIS and the adjacent invasive area of ductal type (H&E x 40). B. Invasive area of ductal type forming cords and nests made of malignant round to polygonal cells. These cells that exhibit clear cytoplasm constitutes more than 90% of the tumor (H&E x 40). C. The granules in the glycogen component of the clear cell are positive for Periodic Acid-Schiff staining (PAS x 40).
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Final pathology confirmed the diagnosis of GRCC carcinoma with extensive solid type clear cell ductal carcinoma in-situ (Fig. 4A). The malignant cells were round to polygonal, forming cords and nests, containing clear cytoplasm and constitute more than 90% of the tumor (Fig. 4B). The glycogen granules in the clear cytoplasm are positive (Fig. 4C) for Periodic Acid-Schiff staining (PAS) and negative for diastase-periodic acid stain (d-PAS).