Breast malignant, males, children

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Breast malignant, males, children

Morphologic variants of DCIS

Cribriform DCIS

Reviewer: Dina Kandil, M.D. (see Reviewers page)
Revised: 8 November 2012, last major update January 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Micro description
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● Multiple secondary lumens having round, regular spaces with sharp borders that appear to be made from “cookie-cutters,” usually low grade (image)
● Nuclear palisading around the lumens (the long axes of the nuclei are perpendicular to the lumens
● May have small, regular fenestrations (Latin, the arrangement of windows in a building), giving a sieve-like appearance
● Nuclei are usually small and uniform, equidistant from each other; usually no necrosis
● Trabecular bars: rigid rows of cells with long axes perpendicular or at least not parallel to long axis of the bar (not just partial detachments of duct lining)
● Roman bridges: curvilinear trabecular bars connecting two portions of the epithelial lining (image)

Micro images
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Uniform cells either haphazard or at right angles to long axis of intraductal columns (AFIP)

Prominent Roman bridge (AFIP)

Cribriform growth due to merging of intraductal epithelial bridges

Regular punched out fenestrations and distension of duct

Rigid microlumina




Glandular spaces and monotonous epithelial cells

Round fenestrations

Fenestrations, Roman bridges and trabecular bars


Prominent roman bridges

Classic area (fig c) and areas resembling low grade clinging carcinoma (fig a) and ADH (fig b)


With microcalcifications

ER+

Factor VIII staining shows only rare vascular proliferation (fig 2a); low MIB1 staining (fig 2b)

Other images: glandular spaces and monotonous epithelial cells; low grade cytology but with comedonecrosis #1;; #2; post-chemotherapy

Cytology description
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● Three dimensional structures, occasionally with tumor cells bordering central lumina
● Few single tumor cells
● Clear or slightly hemorrhagic background without necrosis
● Tumor cells are uniform and oval, with round/oval nuclei, finely granular chromatin, indistinct nucleoli, slight nuclear membrane condensation (Acta Cytol 1992;36:48)

Cytology images
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Various images #1 #2 #3

Virtual slides
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Cribriform and solid DCIS

Positive stains
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● ER and PR

Differential diagnosis
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● Atypical ductal hyperplasia: cells are pleomorphic and occupy less than 2 duct spaces
● Collagenous spherulosis: intraductal lumina of hyaline, acellular eosinophilic spherules lined by myoepithelial cells
● Adenoid cystic carcinoma: true glandular lumina lined by ductal epithelium and eosinophilic “cylinders” with basement membrane material lined by basal cells; usually ER- and PR- CD117+ luminal cells, p63+, calponin and smooth muscle actin negative

End of Breast malignant, males, children > Morphologic variants of DCIS > Cribriform DCIS

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