Case 262 - Discussion

Uploaded: 2008-10-07, Updated: 2011-03-09

 

 

Chromogranin E-Cadherin

NSE S100
ER: 88%

PR: 64%

Her2/Neu: 0.3, not amplified

Ki-67: 7%

Synaptophysin  

 

INVASIVE CARCINOMA WITH ENDOCRINEDIFFERENTIATION

(ARGYROPHILIC CARCINOMA)

  • Rarely secrete hormonal products and cause clinical symptoms.

  • Clinical presentation similar to other breast cancers without distinctive clinical or mammographic features.

  • Variable histologic appearances. Argyrophilic carcinomas represent a heterogeneous group of tumors, and the true endocrine differentiation is defined by immunostainsfor endocrine markers.

    • No overt morphologic evidence of endocrine differentiation but show endocrine differentiation by IHC; or

    • Histologic features suggestive but not diagnostic of endocrine differentiation; or

    • Organoid growth pattern with uniform epithelioid or spindle cells arranged in trabeculae and ribbon-like configurations.

    • Some tumors with typical endocrine morphology fail to show histochemical evidence of argyrophilia.

  • DDX: metastatic carcinoids.

  • IHC:  Usually ER+,  PR+  and lack of HER2 over-expression.

  • Prognosis: similar to invasive ductal carcinoma, NST.

Reference: Biopsy Interpretation of the Breast by Stuart J. Schnitt, Laura C. Collins