A Case of Neuroendocrine Ductal Carcinoma in situ Found by Bloody Nipple Discharge

Abstract

A 64–year–old woman reporting a bloody left–breast nipple discharge was not found in mammography or ultrasonography to have a palpable mass or other abnormality. Nipple discharge Cytology findings were benign. Mammary ductography, however, showed a duct stricture and peripheral dilation of the duct. The in ability to deny malignancy necessitated lobular duct segmentectomy. Histopathological findings showed solid and papillary ductal carcinoma in situ (DCIS). Tumor cells had numerous fine eosinophilic granules in eosinophilic cytoplasm and nuclei were polarized in HE staining. Cytoplasmic tumor cell granules reacted positively to chromogranin A and most tumor cells reacted positively to synaptophysin. Tumor cells were positive for both ER and PgR. The final diagnosis was neuroendocrine DCIS– a differential diagnosis to be considered in cases of bloody nipple discharge without other evident abnormalities.