Ductal Carcinoma
In Situ
353
producing a distinct ring between the neoplastic epithelial
cells and the basement membrane. This configuration is
often accompanied by accentuation of the basement mem-
brane itself, as well as a circumferential periductal collar of
desmoplastic stroma. A “cocktail” of antibodies to smooth
muscle myosin-heavy chain (SMM-HC) and p63 is especially
sensitive for detecting myoepithelium in high-grade DCIS.
120
Elastosis occurs around some ducts with this periductal reac-
tion. Rarely pronounced neovascularity is represented by a
partial or complete ring of capillaries external to the base-
ment membrane
101
(Fig. 11.28). A variable inflammatory in-
filtrate is present in the periductal stroma. In some instances,
this consists of lymphocytes and histiocytes in amounts
ranging from sparse to very abundant. A more conspicu-
ous granulomatous inflammatory reaction may be elicited in
foci where the duct wall is partially disrupted, and it appears
that necrotic contents of the duct have been discharged or
microinvasion is suspected (Fig. 11.29). Calcification can be
FIG. 11.24.
DCIS, cribriform.
A:
Apocrine features.
B,C:
Low
to intermediate nuclear grade with necrosis
.
FIG. 11.25.
DCIS, cribriform.
A,B
: The affected ducts show central necrosis, high nuclear grade, and
irregularly shaped microlumina.
A
B
