Legends for Breast carcinoma:
1. A screening mammogram showing a 3cm multilobulated spiculated highdensity mass within the left breast superior aspect, approximately 11:00
position deep against the chest wall, highly suggestive of malignancy.
2. A Brain MRI wo/w contrast showing a lesion in the peripheral left occipital
lobe, 1.3 x 1.1 x 1.8 cm, demonstrating contrast enhancement. Centrally
within the lesion is an area of T1 and T2 hypointensity which may represent
necrotic debris. The findings were considered consistent with a solitary
metastatic deposit, given the history.
3. Brain MRI, Lateral view of the same.
4. Imprint smear of the initial lumpectomy specimen submitted for frozen section
showing highly cellular smears with groups of cells with large hyperchromatic
nuclei in a background of necrosis and inflammatory cells. (H/E,20x)
5. Frozen section of the breast lump showing Infiltrating ductal carcinoma.(10x)
6. Permanent section of the breast lump showing Ductal carcinoma in situ (DCIS
- Comedo pattern with central necrosis) along with invasive glands. (H/E, 10x)
7. Poorly differentiated Invasive Ductal carcinoma showing numerous
carcinomatous glands invading through a desmoplastic stroma. (H/E, 10x)
8. Invasive ductal carcinoma invading through fat. (H/E, 10x)
9. Higher power view showing poor tubule formation, large nuclei with nucleoli
and many mitotic figures (poor Elston grade). (H/E, 40x).
10. Ductal carcinoma in situ – cribriform pattern, showing high n/c ratio, nuclei
with nucleoli and mitotic figures. (H/E, 20x)
11. Two ducts with DCIS showing central calcification. (H/E, 10x)
12. Another DCIS with calcifications. (H/E, 20x)
13. Lymphatic invasion by carcinoma. (H/E, 20x)
14. Section of the blue inked surgical margin of the Lumpectomy specimen
showing tumor at the margin. (H/E, 10x)
15. Another section showing a black inked positive margin. (H/E, 10x)
16. A control section showing positive nuclear staining for progesterone
receptors, which showed less than 5% positivity in the invasive tumor.
17. A control section showing positive nuclear staining for estrogen receptors,
while the tumor showed no positive staining.
18. A section of the tumor showing DCIS with positive staining for Her-2/neu.
19. A gross picture of Lungs showing multiple whitish metastatic nodules all over
the surface.
20. C/S of Lung showing multiple whitish nodules.
21. C/S of the liver showing multiple confluent yellowish white metastatic nodules.
22. A part of vertebral column with whitish areas of metastatic carcinoma.
23. &25. A section through Lung showing metastatic breast carcinoma, with
necrosis in the second section. (H/E, 10x &20x)
26. A section of small intestine showing metastatic carcinoma. (H/E, 10x)
27. Metastatic breast carcinoma in the liver. (H/E, 20x)
28. Metastatic carcinoma in the brain.(H/E, 20x)
29. A section through the cardiac muscle fibres showing metastatic carcinoma.
(H/E, 10x)
30. Metastatic carcinoma seen in the muscle fibres of the diaphragm. (H/E,10x)
31. A section of thyroid showing metastatic breast carcinoma.(H/E, 20x)
32. A section through the vertebral bone showing metastatic carcinoma. (H/E,
10x)