Metastatic secretory papillary-columnar, cuboidal and polygonal clear cell components were negative for Her2neu receptors2 3
except single focus of polygonal clear cell type (<5% of tumour area) showing Her2neu positivity (). All the other carcinoma loci in the breast section were negative for Her2neu (). A patch of false positivity appeared in one corner of the section. A report from a sister institute of medical education (on blinded diagnosis) concluded the primary and the metastatic lesion as negative for the Her2neu receptor marker.
(A) Her2neu receptor status of columnar secretory and (B, C) cuboid and polygonal secretory carcinoma.
Patch of false positive Her2neu staining at the margin of the section.
Progesterone receptor staining was negative in the tumour loci comprising of polygonal cells with large nuclei, high nuclear cytoplasmic ratio and thick (low glycogen) cytoplasm characteristic of primitive lactiferal ectodermal cell (PLEC) carcinoma (). Loci comprising of similar cells with comparatively thin cytoplasm (higher glycol content) showed occasional scattered cells showing progesterone receptor marker positivity (). Loci of myoepithelioid granulomatous carcinoma (MGC), including the myoepithelioid giant cells, displayed progesterone receptor negativity (). The clear, cuboid and columnar cell areas of the secretory (lactating) carcinoma component in the primary and metastatic tumour showed strong focal positivity (about 50% of total area of secretory carcinoma) for the progesterone receptors (). A marker expert from the sister institution reported 50% focal positivity of the tumour for the progesterone receptor marker.
Figure 3 Progesterone receptor negative status of primitive lactiferal ectodermal cell (PLEC) carcinoma locus (A), scattered positivity in PLEC transient to early secretory carcinoma (B) and progesterone receptor negative status of myoepithelioid granulomatous (more ...)
Progesterone receptor status of cuboid-polygonal secretory (A) and columnar papillary lactating carcinoma (B).
Metastatic secretory carcinoma in the lymph node showed focal, varied intensity, oestrogenic receptor marker positivity in 80% of the tumour area (). In the breast, tumour loci of PLEC carcinoma were oestrogenic receptor negative (). Areas of PLEC transient to early secretory (thin cytoplasm) stained faintly positive (). Loci of MGC with giant cells were oestrogenic receptor negative () and seen in direct vicinity to the foci of bipolar differentiation of PLEC carcinoma into oestrogen-receptor positive (apical/secretory variant) cells intermingled with negative (primitive myoepithelioid variants) cells (). Loci of very small cell carcinoma (reflective of primitive epiderm type and neurocrine metaplastic elements) and 20–30% of secretory (including columnar) carcinoma were oestrogenic receptor marker negative. The rest of the secretory carcinoma was positive. An expert reported 80% focal positivity of the tumour for the oestrogenic receptor marker. An attempt is made to summarise, locus wise, oestrogen-progesterone-Her2nue receptor status results in the presently heterogeneous carcinoma of the breast ().
Oestrogenic receptor status of secretory/lactating carcinoma.
Figure 6 Oestrogenic receptor status of the primitive lactiferal ectodermal cell carcinoma (A,B), early secretory carcinoma (C), myoepithelioid granulomatous carcinoma (D) and adjoining loci of bipolar differentiation with respect to oestrogenic receptor (E,F). (more ...)
Summary results of oestrogen-progesterone-Her2neu receptor status in different loci/foci of heterogeneous carcinoma of the breast.