case_images: PMC3461286_01
case_images: Larger tumour: conventional invasive ductal carcinoma of histological grade 3, with extensive necrosis and marked desmoplastic stromal reaction (hematoxylin-eosin stain, x40).
case_images: CRIM.PATHOLOGY2012-387045.001.jpg
case_images: PMC3461286_01_CRIM.PATHOLOGY2012-387045.001.jpg
case_images: fig1
case_images: Microscopically, the larger tumour was diagnosed as conventional poorly differentiated IDC, with high degree of cytologic atypia, numerous mitotic figures, and widespread geographic necrosis as well as with signs of angioinvasion to the lymphatic vessels (Figure 1).
case_images: Smaller tumour: lipid-rich carcinoma of the breast, with atypical large vacuolated cells arranged in clusters, calcifications are seen in upper part of the picture (hematoxylin-eosin stain, x200).
case_images: CRIM.PATHOLOGY2012-387045.002.jpg
case_images: PMC3461286_01_CRIM.PATHOLOGY2012-387045.002.jpg
case_images: fig2
case_images: The smaller neoplastic lesion was composed of large polygonal cells arranged in infiltrating solid and micropapillary formations, with abundant eosinophilic, vacuolated, and foamy cytoplasm (Figure 2).
case_images: Electron microscopy: lipid-rich carcinoma cells with larger lipid vacuoles as well as with numerous lipid droplets in the cytoplasm.
case_images: CRIM.PATHOLOGY2012-387045.003.jpg
case_images: PMC3461286_01_CRIM.PATHOLOGY2012-387045.003.jpg
case_images: fig3
case_images: Vacuoles completely filled the cytoplasm of the cells and had marked membranes (Figure 3).
case_images: Lipid-rich carcinoma: immunohistochemical positivity of HER-2 (HercepTest Dako).
case_images: CRIM.PATHOLOGY2012-387045.004.jpg
case_images: PMC3461286_01_CRIM.PATHOLOGY2012-387045.004.jpg
case_images: fig4
case_images: Immunohistochemically, both carcinomas were negative for oestrogen (ER) and progesterone receptor (PR), cytokeratin 20, alpha-fetoprotein, HepPar-1 and WT-1, and were diffusely positive for HER-2 (Figure 4), p53, E-cadherin, cytokeratin 7, mammaglobin, and carcinoembryonal antigen.