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Table of Contents
Definition / general | Terminology | Epidemiology | Clinical features | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosisCite this page: Kandil D Neuroendocrine DCIS. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantneuroendocrineDCIS.html. Accessed March 23rd, 2019.
Definition / general
- DCIS in which 50% or more cells express neuroendocrine markers (Histopathology 2008;53:288)
- Regarded by some as DCIS with neuroendocrine features rather than a distinct type
Terminology
- First described in 1985 (Histopathology 1985;9:21)
- Also called endocrine DCIS, intraductal or solid papillary carcinoma (Am J Surg Pathol 1995;19:1237)
Epidemiology
- 7% of DCIS cases
- Mean age 70 years, usually > age 60 years (Zhonghua Bing Li Xue Za Zhi 2006;35:594)
Clinical features
- May have associated invasive component, either mucinous (colloid) or with neuroendocrine features (Am J Surg Pathol 1996;20:921)
- Presents as breast mass or nipple discharge (Am J Surg Pathol 1996;20:921)
- Associated with intraductal papilloma and pagetoid involvement by tumor cells
- Neuroendocrine markers are expressed in 67% of solid intraductal papillary carcinomas (Virchows Arch 2007;450:539)
- Almost all DCIS with spindle cells have neuroendocrine differentiation (Histopathology 2004;45:343)
Case reports
- 68 year old woman with 1.5 cm breast nodule (Am Surg 2000;66:1163)
- 72 year old woman with breast mass (Case of the Week #45)
Microscopic (histologic) description
- Solid lobular growth, neuroendocrine-like festoons and rosettes and prominent fibrovascular septa
- Cells are polygonal, oval or spindled with abundant granular eosinophilic cytoplasm and bland ovoid nuclei
- Accumulation of basophilic intracellular mucin
- Often pagetoid spread and well developed vascular network
- Variable stromal sclerosis or signet ring cells
- Usually no necrosis
Microscopic (histologic) images
Focal Grimelius+ cells
Small cells with
dense, deeply stained
amphophilic cytoplasm
and uniform round nuclei
Case of the Week #45
Synaptophysin
Cytology description
- Plasmacytoid tumor cells and arborizing papillary fronds (Cancer 2000;90:286)
Cytology images
Images hosted on other servers:
Various images
Positive stains
Electron microscopy description
- Dense core neurosecretory granules, larger mucigen granules
Differential diagnosis
- Florid epithelial hyperplasia and papilloma: lacks the monomorphic cell population associated with DCIS, negative for neuroendocrine markers
