Breast malignant
In situ carcinoma
Cystic hypersecretory DCIS

Topic Completed: 1 January 2012

Minor changes: 25 June 2020

Copyright: 2002-2019,, Inc.

PubMed Search: Cystic hypersecretory DCIS

Dina Kandil, M.D.
Page views in 2020 to date: 19
Cite this page: Kandil D. OLD Cystic hypersecretory. website. Accessed August 7th, 2020.
Definition / general
  • Rare (< 100 cases described); usually large palpable mass with pain
  • Mean age 55 years, range 32 - 79 years
  • 20% are associated with an invasive component, usually poorly differentiated ductal carcinoma with solid growth pattern and no secretory features
Case reports
Prognosis and treatment
Radiology description
  • Single, irregular, spiculated mass with occasional calcifications
Gross description
  • Numerous cysts with sticky, mucoid or gelatinous secretions
Microscopic (histologic) description
  • Dilated ducts and cysts containing homogenous eosinophilic secretions resembling thyroid colloid
  • Secretions may retract from epithelium, causing smooth or scalloped margin
  • Lining epithelium usually grows as micropapillary DCIS
  • DCIS is usually low grade
Microscopic (histologic) images

Case of the Week #35

Variably sized cysts

Cysts lined by flattened epithelium

secretions show
cracks and shrinkage
of cyst content with
peripheral scalloping

Cysts lined by
projections with
atypical cells containing
pleomorphic nuclei

AFIP images

Micropapillary type pattern
with prominent secretion

Hobnail type cells

intraductal carcinoma
and sparse secretion
retracted from epithelium

Images hosted on other servers:

Fig 1: color Doppler is suggestive of cancer
Fig 2: FNA shows sparsely cellular smears with groups of cells in 3 dimensional clusters, papillary formation and granular background (inset: hyperchromatic cell with increased N/C ratio)
Fig 3: core biopsy shows dilated ducts with papillary proliferation
Fig 4: excision shows dilated ducts with micropapillary architecture and eosinophilic colloid-like material

Cytology description
  • Distinct granular, colloid-like material in background
  • Often reported as negative or suggestive of malignancy
Positive stains
Negative stains
Differential diagnosis
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