Morphologic Study of Carcinoid-Like Tumors and Their Relation to True Carcinoids,Using Tumors of the Breast as a Model

Two cases of an unusual type of infiltrating ductal carcinoma of the breast are presented. Both cases demonstrated a carcinoid-like pattern and were indistinguishable from carcinoid tumors of the breast by light microscopy. However, Grimelius stains and electron microscopic evaluation showed no evidence of membrane bound secretory granules. In regard to the prognostic significance and proper classification of carcinoids of the breast, awareness of carcinoid-like morphologic variants of infiltrating ductal or lobular carcinoma is important. It is also apparent that there is a spectrum of tumors which demonstrate some properties of true carcinoids, however, only the true carcinoids show a better prognosis and it serves no useful purpose to separate the rest of these tumors. The diagnosis of carcinoid tumors requires demonstration of secretory granules on electron microscopic examination or in special stains; conventional light microscopic studies alone are insufficient for this diagnosis. All these principles may be applied to carcinoid like tumors of other sites.