title: "High-grade" central acellular carcinoma and matrix-producing carcinoma of the breast: correlation between ultrasonographic findings and pathological features.
abstract: High-grade carcinoma with a large central acellular zone (central acellular carcinoma, CAC) and matrixproducing carcinoma (MPC) are aggressive tumors that both have a central myxomatous acellular zone. Their characteristic morphology may be useful in diagnostic imaging. Ultrasonographic findings based on the Breast Imaging Recording and Data System (BI-RADS) and detailed histological features were evaluated in 11 cases of CAC and 2 cases of MPC to characterize their features. Safranin-O staining was undertaken for the evaluation of central acellular zones in these tumors. Overall, ultrasonography demonstrated heterogeneous hyperechoic lesions in the center of the hypoechoic mass. Posterior echo enhancement was observed in all but 1 case. One case was classified as malignant and the others as "borderline." Histologically, cancer tissue was located in the periphery of the tumor with a ring-like structure and fewer cellular central areas comprising hyaline cartilage myxoid material such as those stained by safranin-O. The present study showed that the pathological findings of CACs and MPCs accurately reflect the ultrasonographic findings. Tumors that showed hyperechoic areas in the center of the hypoechoic mass, with posterior echo enhancement indicating acellular zones composed by myxochondroid material, and that were also relatively round on ultrasonography may be benign, but evaluation is required to exclude CAC and MPC.
authors.affiliation: Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. rin@med.kurume-u.ac.jp
authors.forename: Rin
authors.initials: R
authors.lastname: Yamaguchi
authors.forename: Maki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Mizushima
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hirai
authors.forename: Miki
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Terasaki
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
mesh_terms: D001940:Breast / Q000378:metabolism / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D047368:Tumor Burden; D014463:Ultrasonography