PMC7662442_01
(A) Sonographic examination of the right axilla revealed an irregularly shaped hypoechoic mass with unclear borders and uneven internal echoes. (B) Color Doppler ultrasonography (B) depicted spot-like blood flow signals around the mass.
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F1
Sonographic examination revealed an irregularly shaped hypoechoic mass with unclear borders, uneven internal echoes, and dimensions of ~3.4 x 3.4 x 1.9 cm in the right axilla (Figure 1A). Color Doppler ultrasonography depicted spot-like blood flow signals around the mass (Figure 1B).
Pathology of the low-grade adenosquamous carcinoma. In photomicrography (original magnification x100) scattered small glandular ducts and nests of squamous differentiated cells were evident in the sclerosing stroma. The glands were elongated, with angulated (red arrow), comma shaped (green arrow), or polliwog-shaped (yellow arrow) appearances in a disordered infiltrative pattern. The nests of squamous cells (black arrow) were mostly solid bands, and some of them formed keratocysts, of various sizes. Mitosis was rare. Peripheral lymphocyte proliferation (blue arrow) and multinucleated giant cell responses were evident in the periphery.
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F2
This finding was inconsistent with the postoperative pathology report, which suggested LGASC (Figure 2).
Immunohistochemistry staining of the low-grade adenosquamous carcinoma (original magnification x100) revealed positive expression of p63 (A), weakly positive expression of estrogen receptor (B), low expression of Ki-67 (C), and no expression of progesterone receptor (D) or human epidermal growth factor receptor 2 (E).
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F3
The results of quantitative immunohistochemical analysis were ER 15%, PR negative, HER2 negative, p63 positive, and Ki-67 10% (Figure 3).