Histopathology

SDC resembles intraductal and infiltrating mammary duct carcinoma, both architecturally and cytologically. The diagnostic "ductal lesion" comprises pleomorphic, epithelioid tumour cells with a cribriform growth pattern, "Roman bridge" formation, and intraductal come-donecrosis. The tumour infiltrates and metastasizes with a cribriform pattern, or it totally recapitulates the intrasialodochal "ductal lesion". Solid and papillary areas may be seen, with psammoma bodies, as well as evidence of squamous differentiation. Cytologically, these cells have abundant, pink cytoplasm and large pleomorphic nuclei with prominent nucle-oli and coarse chromatin. The cytoplasm may also be densely eosinophilic, granular, or oncocytic. Mitotic figures are usually abundant. Goblet cells are not seen. Rare tumours may have a prominent spindle cell or sarcomatoid growth pattern similar to the metaplastic ductal carcinomas of the breast {1064,1819,}. The mucin-rich SDC is a recently described variant of SDC {2371}. The tumour is composed of areas of typical SDC, but in addition, contains mucin lakes with islands of carcinoma cells. Another variant showing an invasive micropapillary component has also been reported {1820}.

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