case_images: PMC9791177_01
case_images: (A, B) CT showed high-density masses located in the lateral upper quadrant of the left breast. (C) Non-special type of invasive breast cancer. Immunohistochemistry showed that malignant cells are positive for ER (D) but negative for Syn (E).
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case_images: f1
case_images: Computed tomography (CT) scans showed that nodules focus in the left breast with blurred margins and marked enhancement (Figures 1A, B). Microscopically, tumor 1 was a non-special type of invasive breast cancer, histologically grade 2 (Figure 1C). Immunohistochemistry in tumor 1 showed that these malignant cells were positive for estrogen receptor (ER) but negative for synaptophysin (Syn) (Figures 1D, E).
case_images: (A) Invasive carcinoma of the breast with signet ring feature. Immunohistochemistry showed abnormal cells are positive for ER (B), HER-2 (C), Syn (D), E-cadherin (E), but negative for PAS (F).
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case_images: f2
case_images: Meanwhile, many tumor cells contained eccentric, clear paranuclear vacuoles resembling signet ring cells (Figure 2A). At the same time, immunohistochemistry in tumor 2 showed that these malignant cells were positive for ER (Figure 2B) and GATA binding protein 3 (GATA-3) but negative for epidermal growth factor receptor (EGFR) and cytokeratin 5/6 (CK5/6). HER-2 status was 2+ (Figure 2C) and fluorescence in situ hybridization (FISH) demonstrated heterogeneity in HER-2 gene amplification in this tumor tissue (Figure 3A). Syn and E-cadherin immunopositivity were on the tumor membranes (Figures 2D, E). Special staining for periodic acid-Schiff stain (PAS) was negative (Figure 2F).
case_images: (A) HER-2 detection by FISH, HER-2/CEP17>2.0. (B) Electron microscopy shows aggregation of numerous neurosecretory granules (black arrows) and intermediate filaments (white arrows).
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case_images: PMC9791177_01_fonc-12-1029007-g003.jpg
case_images: f3
case_images: HER-2 status was 2+ (Figure 2C) and fluorescence in situ hybridization (FISH) demonstrated heterogeneity in HER-2 gene amplification in this tumor tissue (Figure 3A). Electron microscopy confirmed that the neurosecretory granules in the cytoplasm were clustered or locally distributed with intermediate filament aggregation (Figure 3B).