PMC4239127_01
(a). Mammography, mediolateral oblique view showing well defined, lobulated radio-opacity in the right inferomedial quadrant. (b). The cut surface of the mass showing cysts filled with gelatinous secretions.
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figure1
A mammography showed a well-defined, lobulated radio-opacity in the inferomedial quadrant of right breast (Figure 1a).
Microscopic findings (H & E). The lesion is composed of multiple cyst and ducts containing eosinophilic secretions (a; 40x). Some of the cysts are lined by flattened epithelium (a; 40x) while others show epithelial proliferations in form of pseudostratification, knobby tufts (b; 100x), Roman arch (c; 100x), to micro-papillary carcinoma in situ (d; 630X), and invasive pattern in form of solid sheets (e; 100x), and papillary pattern of ductal carcinoma (f; 100x).
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figure2
Microscopically, the tumour showed varied histological pattern with predominantly multiple variable- sized cystic spaces filled with PAS positive dense eosinophilic material resembling thyroid colloid (Figure 2a). The cyst lining epithelium exhibited a variable pattern that in most areas was flat to cuboidal (Figure 2a) and in other areas showed a proliferative change in the form of pseudostratification to knobby epithelial tufts (Figure 2b) to complex branching fronds that extend across duct lumen forming a Roman arch bridging pattern (Figure 2c). Areas of intraductal carcinoma (micropapillary type) (Figure 2d) accompanied by an invasive component comprising of solid pattern of moderately to poorly differentiated ductal carcinoma cells (Figure 2e) was seen. Some areas of tumour tissues also showed papillary pattern with fibrovascular core (Figure 2f).