Tubulolobular breast carcinoma

Case contributed by Henry Knipe


Breast lump.

Patient Data

Age: 65
Gender: Female

After informed consent, using sterile technique and sonographic guidance, the rounded hypoechoic densely shadowing lesion in the right breast at the six o'clock position 8 cm from the nipple was biopsied using a 14 gauge core needle.

CLINICAL NOTES: Likely primary breast carcinoma.

MACROSCOPIC DESCRIPTION: "R breast core": Two white yellow tissue cores 15 and 17mm. A1.

MICROSCOPIC DESCRIPTION: Serial sections show extensive involvement of each of the two cores by invasive carcinoma. The tumor consists largely of well formed tubular structures lined by moderately pleomorphic cuboidal epithelial cells. These have round and oval hyperchromatic nuclei and a variable amount of pale cytoplasm. Other areas of the tumor are composed of linear aggregates of similarly atypical cells within a dense fibrous stroma. The extension of tumor into adjacent adipose tissue is noted. No mitotic figures are identified. No immunostainin for E-cadherin is seen in tumor cells. The features are of tubulolobular invasive carcinoma.

DIAGNOSIS: Right breast core: Tubulolobular invasive carcinoma.

ESTROGEN RECEPTORS ARE DETECTED (+++ nuclear staining in 20-30% of tumor cells)

PROGESTERONE RECEPTORS ARE NOT DETECTED (++ nuclear staining in <10% of tumor cells) HER-2 NEGATIVE (no staining) 

Case Discussion

Tubulolobular carcinoma is a rare histological subtype of tubular breast carcinoma

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