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Image of the Quarter (2013-3)



Use of pan CK immunohistochemistry to identify subtle invasive foci associated with high grade DCIS



50 year old woman - small screen-detected distortion of architecture - core biopsy.




The core shows high grade DCIS. Note patchy periductal fibrosis and chronic inflammation - often a pointer to associated invasion. 'Mouse-over' for closer view.

High grade DCIS with small foci of invasion



This closer view shows single cell invasion adjacent to the duct. 'Mouse-over' for 'Arrows'.

High grade DCIS with small foci of invasion


Low power view with DCIS and single cell invasion (left of centre) picked out by pan cytokeratin immunostain

High grade DCIS with small foci of invasion - pan CK immunostain

This closer view shows single cell invasion adjacent to the duct. 'Mouse-over' for further detail.

High grade DCIS with small foci of invasion

This further view shows nests of invasive tumour. 'Mouse over' for corresponding CK14.

High grade DCIS with small foci of invasion


These two views show pan cytokeratin and CK14 immunohistochemistry.
The pan CK on the left shows single cell invasion while the CK14 shows DCIS on the right hand side of the image with an intact (CK14 positive) myoepithelial layer and nests of invasive epithelial cells on the left hand side of the image (circled) with no associated myoepithelial elements.


High grade DCIS with small foci of invasion - pan CK immunostain High grade DCIS with small foci of invasion - CK14 immunostain



See also Uses of immunohistochemistry in the diagnosis of DCIS v invasion.

See also Use of CK5/6 immunostaining to investigate possible invasion in DCIS.

See also... Carcinoma in situ on this site.

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