PMC3123911_01
(a, b) Breast MRI demonstrated regional enhancement in the left superior breast extending to the chest wall and diffuse skin thickening.
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fig1
Breast ultrasound revealed a solid mass in the 9 and 10 o'clock regions of the left breast, and breast MRI demonstrated diffuse enhancement in the left medial superior breast which extended to the chest wall (Figure 1).
(a, b) The breast biopsy demonstrated an invasive adenocarcinoma with a focal cribriform pattern, hyperchromatic round to oval nuclei, and brisk mitotic activity (H&E, 100x, 200x). (c) Cytokeratin 20 showed diffuse, positive staining in the tumor (cytokeratin 20, 100x). (d) CDX2, specific for intestinal epithelium, exhibited diffuse nuclear immunoreactivity in the tumor cells (CDX2, 200x).
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fig2
The patient underwent core needle biopsy which revealed a poorly differentiated adenocarcinoma (Figure 2) with neither an in situ component nor lymphovascular space invasion. The tumor was positive for CK20 and CDX-2 (Figure 2), and negative for CK-7, estrogen receptor, progesterone receptor, and HER2/neu by immunohistochemistry and fluorescent in situ hybridization (FISH).