352
Chapter 11
FIG. 11.22.
(Continued)
FIG. 11.23.
DCIS, cribriform.
A,B:
Microlumina with various
shapes.
C:
A circumscribed lobulated focus of cribriform
DCIS with calcifications.
invasive cribriform carcinoma, collagenous spherulosis, and
atypical ductal hyperplasia (ADH). Applying the “ADH-5”
cocktail (a combination of CKs 5/14, 7/18, and p63) in the
differential diagnosis of ADH and DCIS has shown promise
for improving interobserver and intraobserver agreement;
however, the usefulness of this immunostain in a controlled
prospective setting remains to be determined.
119
Comedo DCIS
is described classically as a solid growth of
large carcinoma cells with poorly differentiated nuclei, cen-
tral necrosis, calcification, and, in some but not all cases, a
high mitotic rate (Fig. 11.27). The myoepithelial cell layer is
variably affected and sometimes completely eliminated by
the carcinomatous proliferation. In some instances, the myo-
epithelial cells are hyperplastic with hyperchromatic nuclei,
