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. 2020 Nov 25;478(5):933–941. doi: 10.1007/s00428-020-02971-w

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Intraductal carcinoma. a The unencapsulated tumor composed of variably sized cysts and nests with mainly intraductal proliferations The neoplastic nests contain epithelioid cells with abundant eosinophilic cytoplasm and regular oval and round nuclei with conspicuous nucleoli (H&E × 20). b The cysts contained micropapillary structures, solid areas with irregular fenestrations or cribriform areas(H&E × 20). c–d The neoplastic nests contain epithelioid cells with abundant eosinophilic cytoplasm and regular oval and round nuclei with conspicuous nucleoli (c H&E × 200; d H&E × 100). e Focal mucinous differentiation with PAS-positive vacuoles in the cytoplasm (H&E × 200). f Immunohistochemical staining showed strong membranous expression of ALK in 100% of cells (H&E × 200). g Fluorescence in situ hybridization with ALK Dual Color Break Apart FISH Probe. Nuclei with split red and green signals indicate ALK break (yellow arrows). Chromosome 2 with normal gene shows yellow signal (overlapping green and red and white arrows)