Incipient gynecomastoid hyperplasia of the female breast. A, The duct shows a 3-layered epithelial pattern: an inner layer of luminal cells with smaller nuclei, an intermediate layer of luminal cells with predominantly vertical orientation, and an outer layer of myoepithelial cells. B, Immunostaining for ER selectively highlights the intermediate layer. C, Immunostaining for CK5 selectively highlights the inner and outer layers.
Pagetoid involvement of a duct by ductal carcinoma in situ. A, The inner layer consists of a preexisting luminal epithelium lifted up by the in situ carcinoma cells. The intermediate layer consists of disordered neoplastic cells, with some oriented vertically. The duct is surrounded by an outer layer of myoepithelium. B, Immunostaining for CK5 shows positive staining of the inner luminal layer and the outer myoepithelial layer but not the intermediate layer comprising in situ carcinoma cells.
Da Cheuk W et al, Am J Surg Pathol 2012.
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