Histologic changes: The wall of the cavity is composed of branching, papillary projections with fibrovascular cores. At the base is a fibrous reaction with scattered inflammatory cells. The tumor makes angulated, invasive projections into this fibrous tissue.

At higher magnification, the epithelium shows focal disordered maturation from the basal layer to the surface. The atypical cells are crowded and have increased nuclear/cytoplasmic ratios and vesicular nuclei with clumped chromatin and prominent nucleoli. Many mitoses are present (arrows).

Case 8--Clinical SummaryImage 3

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