Fig. 34

Ductal carcinoma in situ. a Photograph of an 85-year-old woman with a large palpable retroareolar mass with marked involvement of the right nipple-areolar complex. b Synthesized 2D mammogram shows a circumscribed retroareolar mass with associated pleomorphic calcifications. c Ultrasound shows a cystic mass with debris inside and a solid mural nodule with a penetrating vessel in the power-Doppler study. d Hematoxylin-eosin stain (× 10). Fragment of the cyst wall with slight chronic inflammatory involvement and vascular congestion and epithelial lining made up of few layers of markedly pleomorphic elements and dense eosinophilic cytoplasm. Note the proliferation of the papillary pattern, with fronds with wide fibroconnective stems lined with similar pleomorphic elements (intraductal carcinoma within the cyst). e Close-up (Hematoxylin-eosin stain × 20)