368
Chapter 11
FIG. 11.49.
Coexistent intraductal and in situ lobular
carcinoma in a single duct-lobular unit.
A,B:
Mingling of
cribriform DCIS and
in situ
lobular carcinoma. The DCIS is
E-cadherin positive, whereas the LCIS is E-cadherin nega-
tive
(B). C,D:
Cribriform DCIS surrounded by
in situ
lobular
carcinoma.
E:
Solid apocrine DCIS in the center of a duct
with LCIS at the perimeter. (
C,D:
Reproduced from Rosen
PP. Coexistent lobular carcinoma in situ and DCIS in a
single lobular-duct unit.
Am J Surg Pathol
1980;4:241–246,
with permission.)
or HER2 expression. These authors observed that stromal
vascularity was increased in comedo DCIS when there was
marked stromal desmoplasia, but the increased vascularity
was not specifically periductal in distribution.
Other investigators have also studied the association be-
tween the architectural pattern of DCIS and periductal neo-
vascularity. Heffelfinger et al.
165
recorded the distribution
of capillaries in contact with the basement membrane of
ducts in various conditions, including proliferative changes
and DCIS. The mean score for vascularity was increased
significantly between normal and proliferative ducts
(0.187 vs. 0.836) and between both of these categories and
DCIS as a group (1.525). Variations inmean scores were seen
in subtypes of DCIS, ranging from 0.962 for micropapillary
