Clinicopathological study of invasive ductal carcinoma with large central acellular zone: Special reference to magnetic resonance imaging findings

Abstract

Invasive ductal carcinoma (IDC) with central acellular zone is sometimes encountered, but its clinicopathological features have not yet been fully investigated. The clinicopathological features of 10 resected cases of IDC with a large central acellular zone were investigated. The tumor size ranged from 6 to 28 mm with a mean of 14.3 +/- 6.9 mm. Contrast-enhanced magnetic resonance imaging (MRI) showed a ring-like appearance in the tumor. Sagittal fat-suppressed T2-weighted MRI had very high to intermediate signal intensity in a central area. Histologically, cancer tissue was located in the periphery of the tumor with a ring-like pattern and a large central area was occupied by acellular amorphous tissue that was strongly stained by alcian blue. Lymph vessel permeation was seen in eight cases. Among the tumors with focal enhancement in the central areas >1 cm in diameter on contrast MRI, marked increase of microvessel was observed in the enhanced spot. The mean of p53 and Ki-67 labeling indices was 56.2% and 36.3%, respectively. IDC with a large central acellular zone presenting with characteristic MRI should be noted as a new morphological entity.

A Rim-Enhanced Mass with Central Cystic Changes on MR Imaging: How to Distinguish Breast Cancer from Inflammatory Breast Diseases?

“…The average age of breast cancer patients in our study was 55.4 years, older than the patients with inflammatory breast diseases, which is consistent with previous reports [7], [11]. In our study, inflammatory symptoms were considered present if a patient had any symptoms of pain, erythema or heat.…”

“…In benign diseases, it is most commonly seen in inflammatory breast diseases such as different types of mastitis with abscess formation, inflammatory cysts or galactoceles, and fat necrosis [2]–[6]. However, it also could be seen in malignant tumors like invasive ductal carcinoma (IDC), intracystic papilloma or papillary carcinoma, and some rare breast cancers like metaplastic cancer [2], [7]–[10]. Solid nodular protrusion in the wall-like peripheral part of the cystic mass has been described as a specific sign of intracystic papilloma or papillary carcinoma [10].…”

Immunohistochemical study of metaplastic carcinoma and central acellular carcinoma of the breast: central acellular carcinoma is related to metaplastic carcinoma

“…[11][12][13]25 The several differences between MBCs and CACs may occur because CACs usually show residual ductal structures in some parts in cancer areas. These tumors showed a high frequency of being TN, but immunohistochemical analyses could be a potential target for antibody-based therapies of these cancers in the future.…”

“…The remaining 20 patients (some of whom were reported in another study 13,25 ) had cancer with a central acellular zone occupying more than one-third of the tumor area as defi ned by Tsuda et al 9 Thus, cancer specimens from 40 patients were examined by immunohistochemical analyses. None of these patients had received preoperative chemotherapy or hormone therapy.…”

Bilateral primary breast neuroendocrine carcinoma in a young woman: Report of a case

“…14 These reports suggested that the size, stage of disease at the time of diagnosis, expression of the ER and PR, and the Ki-67 index are important determinants of the prognosis. [15][16][17] In this case, the patient has remained free from disease as of her the last follow-up 20 months after her initial diagnosis and surgical management.…”