PMC3461286_01
Larger tumour: conventional invasive ductal carcinoma of histological grade 3, with extensive necrosis and marked desmoplastic stromal reaction (hematoxylin-eosin stain, x40).
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fig1
Microscopically, the larger tumour was diagnosed as conventional poorly differentiated IDC, with high degree of cytologic atypia, numerous mitotic figures, and widespread geographic necrosis as well as with signs of angioinvasion to the lymphatic vessels (Figure 1).
Smaller tumour: lipid-rich carcinoma of the breast, with atypical large vacuolated cells arranged in clusters, calcifications are seen in upper part of the picture (hematoxylin-eosin stain, x200).
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fig2
The smaller neoplastic lesion was composed of large polygonal cells arranged in infiltrating solid and micropapillary formations, with abundant eosinophilic, vacuolated, and foamy cytoplasm (Figure 2).
Electron microscopy: lipid-rich carcinoma cells with larger lipid vacuoles as well as with numerous lipid droplets in the cytoplasm.
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fig3
Vacuoles completely filled the cytoplasm of the cells and had marked membranes (Figure 3).
Lipid-rich carcinoma: immunohistochemical positivity of HER-2 (HercepTest Dako).
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fig4
Immunohistochemically, both carcinomas were negative for oestrogen (ER) and progesterone receptor (PR), cytokeratin 20, alpha-fetoprotein, HepPar-1 and WT-1, and were diffusely positive for HER-2 (Figure 4), p53, E-cadherin, cytokeratin 7, mammaglobin, and carcinoembryonal antigen.