title: Micropapillary carcinoma of the breast with necrosis-like cell death: a case report.
abstract: A primary invasive micropapillary carcinoma of the breast in a 46-year-old woman is reported. Histologically, it was composed predominantly of papillary tumor cell clusters without fibrovascular cores, surrounded by a clear space. Tumor cells were positive for cytokeratin (CK) 7, estrogen receptor (ER), and progesterone receptor (PR), but negative for p53, CK 20, CD34, c-Erb-B2, CK5, epidermal growth factor receptor (EGFR), vimentin, and c-kit. MUC1 expression was found at the reversed apical membrane of neoplastic cell clusters. Accordingly, electron microscopy showed the lack of basement membrane and presence of microvilli at the basal surface of the tumor cells. Moreover, ultrastructural examination revealed single tumor cell death characterized by patchy condensations of chromatin throughout the nucleus. These nuclear alterations were associated with the occurrence of empty cytoplasmic vacuoles, conferring a necrosis-like phenotype to this cell death. Alternative programmed cell deaths are reviewed and their morphologic distinction is discussed.
authors.affiliation: Dipartimento di Patologia Umana, Policlinico Universitario, Messina, Italy. rosariocaruso@tin.it
authors.forename: Rosario Alberto
authors.initials: RA
authors.lastname: Caruso
authors.forename: Rocco
authors.initials: R
authors.lastname: Cicciarello
authors.forename: Maria Ester
authors.initials: ME
authors.lastname: Gagliardi
authors.forename: Francesca
authors.initials: F
authors.lastname: Albiero
authors.forename: Gregorio
authors.initials: G
authors.lastname: Costa
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Renato
authors.initials: R
authors.lastname: Cavaliere
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Finocchiaro
authors.forename: Mario
authors.initials: M
authors.lastname: Mesiti
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cavallari
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D002291:Carcinoma, Papillary / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D002467:Cell Nucleus / Q000648:ultrastructure; D003131:Combined Modality Therapy; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D053552:Keratin-7 / Q000032:analysis; D046529:Microscopy, Electron, Transmission; D008871:Microvilli / Q000648:ultrastructure; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D009336:Necrosis; D011960:Receptors, Estrogen / Q000032:analysis; D014617:Vacuoles / Q000648:ultrastructure
chemical_list: D014408:Biomarkers, Tumor; D053552:Keratin-7; C060192:MUC1 protein, human; D018396:Mucin-1; D011960:Receptors, Estrogen