Figure 1.
An invasive micropapillary carcinoma in a 44-year-old woman with a palpable mass in the left breast. (A) Craniocaudal and mediolateral oblique mammograms show irregular, high-density masses with spiculated margins in the left upper outer quadrant (arrow). An enlarged lymph node with eccentric cortical thickening is seen in the axillary area (arrowhead). (B) B-mode image of the left breast shows an approximately 2.6 cm, irregular, hypoechoic mass with spiculated margins in the 1 o'clock position. (C) B-mode image of the left axilla shows an approximately 2.2 cm, enlarged lymph node with cortical thickening and obliteration of the central fat hilum, which suggests a metastatic lymph node. The lymph node was pathologically confirmed as metastasis. (D, E) Axial, dynamic, contrast-enhanced, T1-weighted MR images of the left breast 2 minutes (D) and 6 minutes (E) after contrast injection show an approximately 3.3 cm, heterogeneous, enhanced mass in the upper outer quadrant. The kinetic pattern was evaluated visually and showed a persistent pattern. (F) 18F-FDG PET maximum intensity projection image shows a subtle increased glucose metabolism (SUVmax=4.6) in the left breast (arrow). Increased glucose metabolism (SUVmax=4.0) is seen in the left axillary lymph node (arrowhead). (G) Photomicrography shows clusters of tumor cells in a micropapillary arrangement that appears to be within clear spaces (H&E stain, ×100; Inlet: positive immunohistochemical stain for estrogen receptor, ×400).