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Correspondence
Infiltrative epitheliosis of the breast
  1. Rin Yamaguchi1,2,
  2. Kanetaka Maeshiro3,
  3. Ian O Ellis4,
  4. Emad A Rakha4,
  5. Jun Taguchi5,
  6. Ichiro Shima3,
  7. Hideki Kamei3,
  8. Minoru Suzuki3,
  9. Mahiro Imamura3,
  10. Gouichi Nakayama3,
  11. Hirohisa Yano2
  1. 1Department of Pathology and Laboratory Medicine, Kurume University Medical Center, Kurume, Japan
  2. 2Department of Pathology, Kurume University School of Medicine, Kurume, Japan
  3. 3Department of Surgery, Asakura Medical Association Hospital, Asakura, Japan
  4. 4Department of Histopathology, Nottingham City Hospital, NHS Trust, Nottingham, UK
  5. 5Department of Pathology, Asakura Medical Association Hospital, Asakura, Japan
  1. Correspondence to Dr Rin Yamaguchi, Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan; rin{at}med.kurume-u.ac.jp

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A 77-year-old woman noted a mass in her right breast, following which she presented to the Asakura Medical Association Hospital (Asakura, Japan). The mass was soft, smooth and round, without lymph node swelling of the axilla, and ∼2.0 cm in size. Her CA19-9 level was slightly high at 39.2 U/ml (normal: <37.0 U/ml). She was involved in a traffic accident 30 years ago. On imaging, mammography showed a regularly shaped mass, while ultrasonography indicated a combination mass with a solid and cystic pattern measuring 2.3×1.1 cm (figure 1). The tumour was therefore considered to be generally benign but solid and had a cystic pattern admixture with unusual ultrasonographic findings. Since malignancy could not be completely excluded, and in accordance with the patient's request, a needle biopsy was performed.

Figure 1

Ultrasonographic findings in the right breast. Ultrasonography demonstrated a tumour with a solid portion and cystic lesions. The tumour showed a heterogeneous echo level with anechoic cystic areas.

The biopsy specimen showed papillary lesions with abundant stromal proliferations. Under low-power magnification, the nodular lesion appeared to be invasive. On the other hand, under high-power magnification, the luminal cells were cytologically bland and appeared jumbled on top of each other, and some parts indicated possible squamous differentiation. Since there was a suspicion of an invasive process having occurred in the tissue, an additional specimen was requested and an open biopsy was performed.

In the follow-up open biopsy specimen, the mass lesion was vaguely nodular with irregular glands together …

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