PMC4807953_01
Ultrasonographic findings of the right breast.. Note: An irregularly shaped hypoechoic 25.8 mm x22.9 mm mass with an indistinct border was detected.
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Ultrasonography showed a hypoechoic 25.8 mm x22.9 mm mass with an irregular and indistinct border (Figure 1).
Contrast-enhanced magnetic resonance imaging findings of the right breast.. Notes: Contrast-enhanced magnetic resonance imaging revealed an irregularly shaped mass with strong enhancement in the early phase. (A) Before the injection of contrast agent. (B) One minute after the injection of contrast agent.
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No intraductal spread of the tumor was detected (Figure 2).
Histopathological findings of the lipid-rich carcinoma.. Notes: Tumor cells with abundant foamy cytoplasm and in situ neoplasm were present (arrow). Hematoxylin and eosin staining (A: x40; B: x400). Sudan IV staining (C: x400) and electron microscopic examination (D: x400) confirmed the presence of cytoplasmic lipid droplets (arrows) that were negative for PAS staining (E: x400). GCDFP-15 staining (F: x400) was negative for the cytoplasm of the tumor cells. Cytokeratin (CK) 5/6 (G: x400) was weakly positive, and p53 was positive in the tumor cells (H: x400).. Abbreviations: PAS, periodic acid-Schiff; GCDFP-15, gross cystic disease fluid protein-15.
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Histopathologically, the tumor cells were abundant in foamy cytoplasm (Figure 3A and B). Sudan IV staining (Figure 3C) and electron microscopic examination of the tumor (Figure 3D) demonstrated the presence of marked cytoplasmic lipid droplets, which were negative for periodic acid-Schiff (PAS) staining (Figure 3E). Furthermore, gross cystic disease fluid protein-15 (GCDFP-15) staining (Figure 3F) was negative in the cytoplasm of the tumor cells. On the other hand, cytokeratin (CK) 5/6 staining was weakly positive (Figure 3G), while p53 staining was positive (Figure 3H).
Immunohistochemical findings of the lipid-rich carcinoma.. Notes: More than 90% of the tumor cells were positive for estrogen receptors (A: x200), ~70% were positive for progesterone receptors (B: x200), all were negative for human epidermal growth factor receptor type 2 (C: x200), and the positive rate of Ki-67 was30% (D: x200).
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Immunohistochemically, ERs and progesterone receptors (PgRs) of the tumor were strongly positive (Figure 4A and B), human epidermal growth factor receptor type 2 (HER2) was negative (Figure 4C), and the ratio of Ki-67-positive cells was ~30% (Figure 4D).