Images in pathology. Dove in flight: who will save the dove?

摘要

A 75-year-old woman underwent removal of the left breast and 18 left armpit lymph nodes. The dimensions of the tumor were 5.5x5x3 cm. The lesion analyzed by the pathologists has been classified as invasive ductal carcinoma, histologich type NAS, G III, with vascular invasion and involvement of the nipple and the derma.Six of 18 lymph nodes show partial and massive metastases with spread to the per-ilymph-nodal tissue. After the immuno-histochemistry analysis of the receptors, FISH (fluorescence in situ hybridization) was performed to estimate the status of the HER2eu oncogene at the DNA level. HER2eu status in breast carcinoma is a prognostic biomarker, and it is a determinant of response to adjuvant therapy.Cancer cells showed a high level of amplification of HER2eu gene that appears as large copy gene clusters of orange signals in the majority of the nuclei. They form circles that encircle nonneoplastic elements (ductal cells) featuring a dove that flies in dangerous territory with expanded wings. Normal cells serve usually as internal negative controls.