Image of the Quarter (2015-6)
Unusual luminal crystals in a patient with mammographic calcification
60 year old screener - widespread mammographic calcification - core biopsy.
There was widespread proliferative disease with foci of intermediate grade DCIS associated with phosphate type calcification.
In the more benign proliferative areas there were oblong luminal crystals ('Mouse-over') which polarised very weakly.
These views show a duct on the left partly filled with an atypical columnar cell proliferation
and showing luminal phosphate-like cacification. The duct on the right shows less severe
changes with a luminal crystalline structure present. The 'Mouse-over' shows weak birefringence with polarised light.
These views show a cluster of benign glands with large numbers of luminal crystals. The'Mouse-over'shows a closer view of the same.
These final views show further detail of these crystals and their appearance under polarised light ('Mouse over').
This is an unusual pattern of crystal accumulation within breast ducts. The association with a columnar cell lesion and some luminal secretions
focally may give a clue to its histogenesis and chemistry. At the moment I (and colleagues whom I have consulted) would favour an oxalate type crystal but we will have to await further analysis
to confirm or deny that assertion.