Breast Cancer - Moose and Doc

A breast cancer explanations website

 

May 5, 2019 By Dr. Halls

Vesicular Nucleus

Each cell has a nucleus. One nucleus usually. If you are talking about one cell having vesicular nucleus, that’s fine. When you are talking about multiple cells, the plural would be vesicular nuclei.

Vesicular Nuclei

Under the microscope, you can see the cells that were from a biopsy specimen, and the pathologists look at the nuclei very closely, day after day. Are there any vesicles, they ask themselves? Do these nuclei look vesicular?, they wonder silently.

Vesicular Nucleoli

Inside of each nucleus, are little structures called the nucleolus. When the pathologist is looking at lots of nuclei and seeing lots of nucleoli, the word nucleoli is pleural.

Dr. Halls Dr. Halls
Sorry for the above, it’s boring simple definitions of words. Lets get onto some good information now.



 
 
When breast cancer cells are described as having ‘vesicular nucleoli’ or ‘vesicular nuclei’, that is two ways to say basically the same thing. It means that large amounts of euchromatin are present. (Euchromatin is a lightly packed form of chromatin (DNA, RNA and protein) that is rich in gene concentration, and is often (but not always) under active transcription of DNA to mRNA products.)

The nucleoli are the little factories inside the nucleus that make the RNA, DNA and proteins. “Those nucleoli are sure making a lot of vesicles” would be like saying there are vesicular nucleoli. “Those nuclei contain a lot of vesicles“, would be like saying there are vesicular nuclei. In other words, the nucleoli secrete the vesicles that end up visible inside the nuclei.

Talking Moose
Talking Moose
Even though that clears it up, I wasn’t actually interested.



 
 

‘Vesicles’ are like little pouches of fluid involved in secretion, (especially protein secretion) and cells with a vesicular appearance tend not to ‘stain’ in an even way. Rather the staining will be patchy or even absent. The outer rim of the cell, however, will tend to be thin and the staining may be concentrated there. The nucleus of the cell, however, will tend to be very densely concentrated with stain, appearing like a dark, almost perfectly circular dot in the middle of an ‘unstained’ space. This is also an indication of large amounts of ‘protein-making activity’ within the cell.

vesicular nucleoli

Vesicular nuclei may indicate a faster growing breast tumor

So, in the context of the cytological and immunohistochemical analysis of cells in a potential breast cancer tumor, the appearance of vesicular nuclei is an indication of heightened levels of hormonal and protein activity, which probably means the cells are in an active and aggressive growing phase. In other words, vesicular nuclei might suggest to the pathologist that the breast carcinoma must be treated aggressively and quite possibly with chemical therapies, but not until the specific hormones and proteins involved are carefully identified and evaluated.

Megan Megan
Ok then. On a biopsy report, when cancer cells have lots of vesicles in their nuclei, it means those cancer cells look geared up to reproduce and grow and, that could be a little scary to read.


Dr. Halls Dr. Halls
But you know, the ‘stage’ and the ‘grade’ will be decided by the oncologists and pathologists, and these extra little phrases on biopsy reports don’t add or subtract anything. They are like accessory extra supernumerary redundant adjectives.



 
 

References

  1. Kleer, Celina G “Carcinoma of the Breast With Medullary-like Features: Diagnostic Challenges and Relationship With BRCA1 and EZH2 Functions”. Archives of Pathology & Laboratory Medicine. Nov. 2009
  2. Foulkes WD, Brunet JS, Stefansson IM, et al. The prognostic implication of the basal-like (cyclin E high/p27 low/p53 /glomeruloid-microvascular-proliferation ) phenotype of BRCA1-related breast cancer. Cancer Res. 2004;64(3):830-835.
  3. Fulford LG, Easton DF, Reis-Filho JS, et al. Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast. Histopathology. 2006;49(1):22-34.
  4. Jaffer S, Emanuel P, Burstein D, Goldfarb A: Cytologic findings of spindle cell dictal carcinoma in situ of the breast: a case report.Acta Cytol 2005, 49:323-326.
  5. Lingamfelter D, Chen Y, Kure K, Lankachandra K.Infiltrating myoepithelial carcinoma of the breast, a case report and cytologic-histologic correlation. Diagn Pathol. 2008 Feb 8;3:7.

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About Steven Halls

Dr Halls has 25 years experience as a radiologist. He worked for 13 years at Cross Cancer Institute in Edmonton, a world-class cancer treatment facility. He has had high-volume experience with cancer, interventional procedures, clinical trials and his own phase 1 and 2 research in MRI and breast cancer staging.

 

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