The nature of breast dense core granules: chromogranin reactivity

Battersby, S.; Dely, C.J.; Hopkinson, Helen; Anderson, T. J.

doi:10.1111/j.1365-2559.1992.tb00939.x

Cited by 14 publications

(8 citation statements)

References 13 publications

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“…Immunoelectron microscopy studies demonstrated the presence of ChA-negative dense core granules in breast carcinomas reactive for ChA in light microscopy (32), and ChA-negative dense core granules were found on the cell apex of solid papillary NE carcinomas (33). The authors presumed that these granules could be positive for other types of Chs.…”

Section: Discussionmentioning

confidence: 99%

Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women

et al. 2001

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Neuroendocrine (NE) breast carcinomas are a rare entity in young women; however, their frequency increases in aged patients. The present work demonstrates that NE breast carcinomas in elderly women can also express an apocrine immunophenotype and analyzes the histological and clinical aspects of such differentiation. A selected series of 50 NE tumors (positive for NE markers in >50% of the cells) was tested for the immunocytochemical expression of gross cystic disease fluid protein-15 (GCDFP-15). The results demonstrated that about 50% of moderately (G2) and well-differentiated (G1) NE breast carcinomas (mucinous, solid papillary, and solid cohesive histotypes) coexpressed the apocrine marker. In these cases, specific mRNA for GCDFP-15 (PIP) and for chromogranin A (ChA) was demonstrated using in situ hybridization (ISH). Carcinomas of the alveolar subtype (G2) and poorly differentiated carcinomas (G3), including one case of atypical carcinoid, were pure NE carcinomas, devoid of apocrine differentiation. The steroid receptor status of these lesions was evaluated to test a possible involvement of androgen receptors in apocrine differentiation. We demonstrated that the level of AR and the mean age of patients at diagnosis were significantly higher in apocrine than in nonapocrine differentiated tumors. The histological grade and the expression of estrogen receptor (ER) significantly influenced the prognosis of these NE carcinomas, either pure or NE-apocrine differentiated. The most original result of our study is therefore the demonstration of a possible divergent apocrine differentiation of NE breast carcinomas that might be regulated by the activation of androgen receptors in elder patients. In addition, the possibility for using Chs or GCDFP-15 serum values in the follow-up of these patients, as demonstrated in two cases of the present series, can justify the immunophenotyping of the tumors.

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Section: Discussionmentioning

confidence: 99%

Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women

et al. 2001

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“…The chromogranins form a family of proteins that includes at least three members: types A, B, and C [41]. Endocrine breast cancers can synthesize either type A or type B; tumours producing only the latter tend to occur in postmenopausal women and pursue an indolent clinical course [2,46]. Both types of chromogranin contribute to the matrix of dense core granules [2,6,37,46] and probably give rise to the granules' argyrophilia [2,3,6,37,41].…”

Section: What Specialized Studies Provide Convincing Evidence Of Neurmentioning

confidence: 99%

“…The latter arise from indigenous endocrine cells and form repetitive histological patterns that do not overlap with those of other types of carcinoma except in unusual examples. Endocrine tumours of the breast probably do not arise from pre-existing endocrine cells, since investigators have observed them only rarely and then only in small numbers [2,3,34,44]. Furthermore, mammary endocrine tumours do not grow with unique histological characteristics; instead the neoplasms often resemble other types of breast cancer and virtually never duplicate the appearances of intestinal or pulmonary carcinoid tumours.…”

Section: Introductionmentioning

confidence: 99%

Carcinomas of the breast with endocrine differentiation: a review

Maluf

Koerner

1994

Vichows Archiv A Pathol Anat

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The occurrence of endocrine differentiation in some mammary carcinomas seems well-established, but pathologists continue to debate its significance. Contemporary thinking suggests that endocrine tumours of the breast do not constitute a single clinicopathological entity with a consistent histogenesis but rather that endocrine differentiation represents a pathway of neoplastic development available to a range of breast cancers. This pattern of differentiation occurs in tumours with vastly different morphological appearances, such as: ductal carcinoma in situ, mucinous carcinoma, a variant of lobular carcinoma, and low grade invasive ductal carcinoma. Although such tumours share some characteristics with intestinal endocrine neoplasms, the typical pattern of intestinal carcinoid virtually never occurs in mammary lesions. Conventional microscopy permits the diagnosis in most cases. Specialized techniques (histochemistry, immunohistochemistry, and electron microscopy) can serve as the basis for diagnosis in the absence of the appropriate morphological features. Although the system of nomenclature proposed by the World Health Organization for use with endocrine tumours in other organs can be used for endocrine tumours of the breast, only a minority of lesions will fit the established criteria. Most lesions are classifiable in the conventional categories of mammary carcinomas. No special prognostic significance is attached to these tumours at the present time.

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“…In addition, the presence of small and large electron dense granules support this contention, although we acknowledge that such granules as those in case 1 do not always indicate neuroendocrine diVerentiation. 13 The diVerential diagnosis of predominantly clear and spindle cell DCIS includes both apocrine and neuroendocrine DCIS, myoepithelial DCIS, and presumably intraductal variants of glycogen and lipid rich carcinomas, as well as fixation artefact. 2 As distinct entities, apocrine and neuroendocrine DCIS are not uncommon, but their occurrence as a mixed or combined subtype of DCIS with an unusual dimorphic appearance appears to be a rare event.…”

Section: Discussionmentioning

confidence: 99%

Mixed apocrine/endocrine ductal carcinoma in situ of the breast coexistent with lobular carcinoma in situ

Coyne

Dervan²,

Barr³

et al. 2001

Journal of Clinical Pathology

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An unusual mixed form of ductal carcinoma in situ (DCIS) of the breast is described, which exhibits a biphenotypic morphology encompassing a range of differential diagnostic DCIS subtypes. In adddition, immunophenotypic and ultrastructural studies demonstrate neuroendocrine and apocrine diVerentiation, raising questions regarding appropriate classification and biological behaviour. In two cases, coexistence of this mixed form of DCIS with lobular carcinoma in situ (LCIS) in the same duct lobular units is an additional unusual feature that might, at least in some cases, indicate a closer relation between them. (J Clin Pathol 2001;54:70-73) Keywords: lobular carcinoma in situ; ductal carcinoma in situ; apocrine diVerentiation Apocrine diVerentiation is common in invasive breast cancer 1 and it is usually recognised by tumour cells containing granular pink cytoplasm. Less commonly, however, the cytoplasm is foamy or clear. In these circumstances, apocrine diVerentiation is defined by immunohistochemical and ultrastructural characteristics.2 Although apocrine diVerentiation is not rare in ductal carcinoma in situ (DCIS), 3 its manifestation with a predominantly clear cell morphology is unusual. Similarly, neuroendocrine diVerentiation has more recently been characterised by combined morphological, immunohistological, and ultrastructural characteristics, firmly establishing the existence of endocrine diVerentiation in DCIS. 4 As a further illustratration of the heterogeneity possible in preinvasive breast neoplasia, we describe three unusual cases of DCIS showing dimorphic apocrine and neuroendocrine differentiation, two of which showed coexisting lobular carcinoma in situ (LCIS). Materials and methodsTissues were fixed in 10% buVered formalin, routinely processed, and stained with haematoxylin and eosin. For immunohistochemistry, representative sections were selected and, using the avidin biotin technique, staining was performed for the following: E-cadherin (R&D systems, Oxon, UK), S100 protein (Dako, Cambridgeshire, UK), chromogranin (Dako), synaptophysin (Dako), the oestrogen receptor (Novocastra, Newcastle, UK), the progesterone receptor (Novocastra), gross cystic disease fluid protein (GCDFP-15; Signet, Dedham, Massachusetts, USA), epithelial membrane antigen (EMA; Dako), smooth muscle actin (SMA; Dako), neurone specific enolase (NSE; Dako), MIB1 (Immunotec, Marseilles, France). For electron microscopy, five selected pieces of tissue from case 1 were dewaxed and reprocessed after postfixation in osmium. Sections (1 µm thick) were cut and stained with toluidine blue. Ultrathin sections were cut and stained with uranyl acetate and lead citrate, one of which was from a spindle cell area. Case histories and pathology CASE 1A 45 year old woman had suspicious microcalcification on mammography. An excision biopsy measuring 4.0 × 3.0 × 1.0 cm was performed after needle localisation. Several additional margin shavings from the biopsy cavity were also removed. This was followed by a subcutaneous mastectomy six...

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The nature of breast dense core granules: chromogranin reactivity

Cited by 14 publications

References 13 publications

Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women

Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women

Carcinomas of the breast with endocrine differentiation: a review

Mixed apocrine/endocrine ductal carcinoma in situ of the breast coexistent with lobular carcinoma in situ

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