EURORAD ESR

Case 15106

High-grade DCIS: atypical clinico-imaging presentation

Author(s)
Dr.Teena Sleeba, Dr.Michelle Aline Antony, Dr Krishna Prasad, Dr. Binu Joy

Rajagiri Hospital, Aluva; Chunangamvely Cochin, India; Email:teenasleeba@gmail.com
 
Patient
female, 56 year(s)
 
 
  • Figure 1
    Craniocaudal view

    CCview: Global asymmetry seen in right breast.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 2
    MLO Views

    MLO views: Global asymmetry right breast with mild discrepancy in size better appreciated in MLO views.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 3
    Ultrasound

    US image showing ill marginated hypoechoic lesions with perilesional echogenic halo.

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 4
    Fat suppressed T1W post contrast image

    Ill-defined nodular and linear non-mass like areas of enhancement reaching till the pectoral. Skin and nipple was unremarkable.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 5
    DWI and ADC

    Diffusion restriction seen involving most of right breast.Hypointensity seen on corresponding ADC images

     
    Area of Interest: Breast; Imaging Technique: Catheter arteriography; MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 6
    Post contrast Maximum Intensity Projection images

    MIP Images showing diffuse involvement of right breast.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Neoplasia;
     
     
  • Figure 7
    Photomicrograph

    High-grade DCIS with central comedo-type necrosis (small black arrow). The neoplastic cells demonstrate markedly enlarged nuclei, with significant pleomorphism, coarse chromatin, and lack of polarity (long black arrow).

     
    Area of Interest: Breast; Imaging Technique: Teleradiology; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
  • Figure 8
    Photomicrograph

    Invasive component seen adjacent to DCIS with malignant cells seen in the stroma (black arrow).

     
    Area of Interest: Breast; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
CCview: Global asymmetry seen in right breast.
 
MLO views: Global asymmetry right breast with mild discrepancy in size better appreciated in MLO views.
 
US image showing ill marginated hypoechoic lesions with perilesional echogenic halo.
 
Ill-defined nodular and linear non-mass like areas of enhancement reaching till the pectoral. Skin and nipple was unremarkable.
 
Diffusion restriction seen involving most of right breast.Hypointensity seen on corresponding ADC images
 
MIP Images showing diffuse involvement of right breast.
 
High-grade DCIS with central comedo-type necrosis (small black arrow). The neoplastic cells demonstrate markedly enlarged nuclei, with significant pleomorphism, coarse chromatin, and lack of polarity (long black arrow).
 
Invasive component seen adjacent to DCIS with malignant cells seen in the stroma (black arrow).
 
 
 
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