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1:
Ductal Carcinoma-in-situ : Micropapillary
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Comments: The micropapillary variant of DCIS showing slender elongated epithelial fronds projecting into the glandular lumen. These projections are solid and lack true fibrovascular cores. They are composed of a uniform population of tumor cells with intermediate nuclear grade.
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2:
Ductal Carcinoma-in-situ : Micropapillary
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Comments: The papillae in this case of micropapillary DCIS range from small bumps or mounds of tumor cells to slender papillary structures. The nuclear grade is high. Some of the papillary fronds projecting into the lumen may be cut transversely resulting in appearance of small detached irregular clusters of tumor cells in the lumen (as seen here). Cellular debris, usually a feature of cases with high nuclear grade, is also present in the lumen.
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3:
Ductal Carcinoma-in-situ : Micropapillary
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Comments: The papillary structures in this example of micropapillary DCIS show bulbous expansion of their tips. Some of the adjacent papillary fronds have coalesced creating Roman bridge arches. When fusion between adjacent fronds is extensive, it results in formation of cribriform structures. Micropapillary and cribriform patterns of DCIS often coexist.
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4:
Ductal Carcinoma-in-situ : Cribriform
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Comments: In the cribriform DCIS, round fenestrations are found within the glands. The more regular these spaces are in size, shape and distribution, the more likely the lesion to be malignant. Cribriform DCIS shows superficial resemblance to adenoid cystic carcinoma and collagenous spherulosis and should not be mistaken for those entities.
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7:
Ductal Carcinoma-in-situ
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Comments: The tumor cells with high nuclear grade nearly fill the lumen in this example of DCIS. The cytoplasmic borders are sharply demarcated.
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8:
Ductal Carcinoma-in-situ
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Comments: Carcinoma cells are present within structures clearly identifiable as a lobule. The lobule is greatly expanded by its involvement with DCIS. The tumor cells have high nuclear grade. The phenomenon of lobular cancerization further supports the notion of terminal duct-lobular unit as the site of origin of many of the intraductal carcinomas.
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9:
Ductal Carcinoma-in-situ : Apocrine
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Comments: This case of DCIS shows apocrine-type cytology with carcinoma cells having abundant granular eosinophilic cytoplasm and pleomorphic nuclei. The architectural pattern is clinging type.
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10:
Ductal Carcinoma-in-situ : Comedonecrosis
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Comments: In DCIS with comedonecrosis, the involved duct shows a solid growth with high nuclear grade along the perimeter of the duct. Mitotic activity is brisk and necrosis is always present in the lumen. Coarse calcifications may be present in the necrosis. The periductal tissue shows fibrosis and evidence of angiogenesis.
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