Image of the Week (19)
Core biopsy - Intracystic/Encysted Papillary Carcinoma
Intracystic papillary cacinoma - note monotonous (single cell type) population of epithelial cells and poorly formed cytoplasmic cores.
Moderate apithelial atypia evident on mouse-over view
Detail from image above: A single cell population is present here but cytological atypia is not marked. 'Mouse over' shows absence of myoepithelial cells on CK5/6 immunostaining
Notes
- It is emphasised that distinguishing benign from malignant papillary lesions can be difficult
- Careful scrutiny to determine whether there is a single cell or dual cell population in the lesion is key
to making the correct diagnosis
- Immunostaining for myoepithelial markers can give considerable support for your diagnosis
- The absence of a peripheral myoepithelial layer around the lesion does not necesarily indicate that the lesion is invasive
Selected references:
1. Collins LC, Carlo VP, Hwang H, Barry TS, Gown AM, Schnitt SJ. Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol. 2006 Aug ;30(8):1002-7.
2. Collins LC, Schnitt SJ. Papillary lesions of the breast: selected diagnostic and management issues.
Histopathology. 2008 ;52(1):20-29.