Microscopic Description -- Shortness of Breath Presenting as Atypical Pneumonia


MICROSCOPIC DESCRIPTION:

Sections of breast tissue (Images 01, 02) demonstrate areas of intraductal (Image 03) carcinoma and areas of invasive (Image 04) ductal carcinoma. The in-situ (Image 03) component demonstrates malignant ductal epithelial confined within the basement membrane of the duct. The invasive (Image 04) component consists of malignant cells derived from ductal epithelium arranged in nests, cords, tubules, and glands. These tumor cells are pleomorphic with smaller cells with slightly hyperchromatic nuclei and larger cells with a high nuclear to cytoplasmic ratio, hyperchromatic nuclei, and prominent nucleoli. The stromal background shows varying degrees of mucin production.

Sections of lung, (Images 05, 06 and 07) liver, (Images 08 and 09 ) and uterus (Images 10 and 11) demonstrate tumor cells adjacent to more normal parenchyma. A section of dura mater (Image 12) demonstrates a large tumor nodule with numerous malignant glands adjacent to normal fibrous tissue.

This section of kidney (Image 13) shows a tumor nodule within the renal parenchyma. The high power view demonstrates a glomerulus (Image 14) surrounded by malignant glandular structures. Note that the glomerulus demonstrates a benign spherical arrangement of capillaries with endothelial lining cells showing small, dense nuclei.

FINAL DIAGNOSIS



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