!DOCTYPE html> Breast malignant, males, children - Medullary carcinoma


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General
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Clinical features
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Treatment and prognosis
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Case reports
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Clinical images
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Mammogram, courtesy of Dr. Mark R. Wick

Gross description
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Gross images
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Courtesy of Dr. Mark R. Wick

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Sharply defined margin with internal nodularity and bosselated surface (AFIP)

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Soft consistency with a fleshy gray appearance

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Locally advanced 7-cm tumor

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Well circumscribed partly cystic grey white

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Atypical medullary carcinoma: primary and nodal metastases

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Gray-fleshy tumor

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Tan-pink tumor with circumscribed margin

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Tumor with extensive hemorrhage

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Well-circumscribed and may be partially cystic

Micro description
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Micro images
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Courtesy of Dr. Mark R. Wick

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More distinct cell borders

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Clusters of sheets of syncytial cells with prominent lymphoplasmacytic infiltrate

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Various images

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Lymphocytes in micropapillary and medullary carcinomas

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ER negative

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p63

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p53

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HER2 staining (usually is negative, in this case, is focally 3+ [see image on right])

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High grade syncytial pattern

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Tumor cells have syncytial pattern and high grade nuclei, necrosis at upper left, lymphoplasmacytic infiltrate at lower right (AFIP)

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A lobule with in situ carcinoma in some lobular units; thick basement membranes, are nonspecific feature (AFIP)

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Focal areas of squamous metaplasia with keratin pearls Note solid growth pattern with distinct cell membranes (not syncytia) in areas of squamous metaplasia (AFIP)



Atypical medullary carcinoma

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Tumor invades fat and is not well circumscribed (AFIP)

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Medullary features include poorly differentiated nuclei, syncytial growth, lymphoplasmacytic infiltrate (AFIP)

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Atypical medullary carcinoma because no lymphoplasmacytic infiltrate

Cytology description
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Cytology images
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Papanicolaou

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Atypical medullary carcinoma

Positive stains
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Atypical medullary carcinoma

Positive stains
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Positive stains
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Negative stains
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Molecular / cytogenetic description
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Positive stains
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FISH and IHC show HER2 amplification

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CISH, heterogeneous expression of HER2, various images

Differential diagnosis
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Additional references
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End of Breast malignant, males, children > Carcinoma subtypes > Medullary carcinoma



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