Misaki Shiraiwa

Intracytoplasmic lipid accumulation in apocrine carcinoma of the breast evaluated with adipophilin immunoreactivity: a possible link between apocrine carcinoma and lipid-rich carcinoma.

Although apocrine carcinoma is a distinct histologic entity, there is no immunohistochemical marker to confirm apocrine differentiation with high sensitivity and specificity, and its differential cytologic characteristics are still not fully clarified. Despite the foamy cytoplasm of some apocrine carcinomas and the existence of lipid in the normal apocrine gland, intracytoplasmic lipid in apocrine carcinomas has not been fully explored. By using immunohistochemistry for adipophilin, which is a specific marker of lipid accumulation that can be applied to paraffin sections, we examined intracytoplasmic lipid in apocrine carcinomas. Twenty-four of 26 (92%) apocrine carcinomas and 38 of 116 (33%) nonapocrine carcinomas contained intracytoplasmic lipid. The frequency of adipophilin-positive cases was significantly higher in apocrine carcinomas compared with nonapocrine carcinomas (P<0.01). The positive cell rate per tumor ranged from 10% to 70% (mean, 29%) for apocrine carcinomas. The staining density was heterogeneous from cell to cell. There was no difference in the staining pattern of adipophilin between apocrine ductal carcinoma in situ and invasive apocrine carcinoma or between eosinophilic cells and foamy cells. Sporadic or mosaic distribution of adipophilin-positive cells throughout the tumor and microvesicular or fine granular cytoplasmic staining with heterogeneous density were characteristic features of apocrine carcinoma. Although intracytoplasmic lipid was identified in most apocrine carcinomas, none of the apocrine carcinomas contained prominent intracytoplasmic lipid in >90% of the tumor cells; thus, the criteria for lipid-rich carcinoma was not fulfilled. However, the immunohistochemical study suggests that lipid-rich carcinomas are closely related to apocrine carcinomas.

Topographical, morphological and immunohistochemical characteristics of carcinoma in situ of the breast involving sclerosing adenosis. Two distinct topographical patterns and histological types of carcinoma in situ.

Moritani S, Ichihara S, Hasegawa M, Endo T, Oiwa M, Shiraiwa M, Nishida C, Morita T, Sato Y, Hayashi T, Kato A, Aoyama H & Yoshikawa K
(2011) Histopathology 58, 835–846
Topographical, morphological and immunohistochemical characteristics of carcinoma in situ of the breast involving sclerosing adenosis. Two distinct topographical patterns and histological types of carcinoma in situ

Representation of Lesion Similarity by Use of Multidimensional Scaling for Breast Masses on Mammograms

Presentation of similar reference images can be useful for diagnosis of new lesions. A similarity map which can visually present the overview of the relationship between the lesions with different types may provide the supplemental information to the reference images. A new method for constructing the similarity map by multidimensional scaling (MDS) for breast masses on mammograms was investigated. Nine pathologic types were included; three regions of interests each from the nine groups were employed in this study. Subjective similarity ratings by expert readers were obtained for all possible 351 pairs of masses. Using the average ratings, MDS similarity map was created. Each axis of the MDS configuration was fitted by the linear model with 13 image features to reconstruct the similarity map. Dissimilarity based on the distance in the reconstructed space was determined and compared with the subjective rating. The MDS map consistently represented the similarity between cysts and fibroadenomas, invasive lobular carcinomas and scirrhous carcinomas, and ductal carcinomas in situ, solid–tubular carcinomas, and papillotubular carcinomas with the experts’ data. The correlation between the average subjective ratings and the dissimilarities based on the distance in the reconstructed feature space was much greater (−0.87) than that of the dissimilarities based on the distance in the conventional feature space (−0.65). The new similarity map by MDS can be useful for visualizing the relationship between breast masses with different pathologic types. It has potential usefulness in selecting the similarity measures and providing the supplemental information.

Uniqueness of ductal carcinoma in situ of the breast concurrent with papilloma: implications from a detailed topographical and histopathological study of 50 cases treated by mastectomy and wide local excision

To clarify the diagnostic clues of ductal carcinomas in situ (DCIS) associated with papilloma and optimal clinical management of papilloma diagnosed on core needle biopsy (CNB).

Correspondence among subjective and objective similarities and pathologic types of breast masses on digital mammography

In multi-modality, multi-information breast cancer diagnosis framework, radiologists take into account all the information available in making diagnosis, one of which can be the information from reference cases. The purpose of this study is to investigate the relationship between pathological concordance and image similarity of breast masses for exploring the utility of similar images and determining the effective similarity index for image retrieval. Twenty-seven images of masses, three from each of 9 pathologic types, were used in this study. Subjective similarity ratings for all possible pairs (351 pairs) were provided by 8 expert readers. Thirteen image features were determined, and their usefulness as a similarity index was examined. Generally, masses with the same pathologic types were considered more similar (0.75) than those with different types (0.43) by the experts, although cysts and fibroadenomas appeared very similar on mammograms. Perimeter, ellipticity, radial gradient index, and full-width at half maximum of radial gradient histogram were considered potentially useful (correlation, r>0.4) for estimating subjective similarity among image features. Similar images together with their clinical data may serve as a useful reference for diagnosis of breast lesions.