Difference between revisions of "Invasive lobular carcinoma"

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#redirect [[Invasive_breast_cancer#Invasive_lobular_carcinoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Lobular_carcinoma_-_high_mag.jpg
| Width      =
| Caption    = Lobular carcinoma. [[H&E stain]].
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[invasive ductal carcinoma of the breast]] with lobular features, poorly differentiated carcinoma, [[LCIS]]
| Stains    =
| IHC        = [[E-cadherin]] -ve, usu. ER and PR +ve, HER2 -ve, [[CK7]] +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  = [[breast grossing]]
| Staging    = [[breast cancer staging]]
| Site      = [[breast]] - see ''[[invasive breast cancer]]''
| Assdx      =
| Syndromes  = [[hereditary diffuse gastric cancer]]
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = relatively common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = other breast tumours
| Tx        =
}}
'''Invasive lobular carcinoma''', abbreviated '''ILC''', is the second most common form of [[Invasive breast cancer]].


It may be referred to as '''lobular carcinoma'''; however, this may lead to confusion with [[lobular carcinoma in situ]].
==General==
*May be associated with a CDH1 mutation - seen in diffuse type [[stomach|gastric]] cancer.<ref>URL: [http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=33006 http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=33006]. Accessed on: 19 April 2011.</ref><ref name=omim192090>{{OMIM|192090}}</ref>
==Microscopic==
Features:
*"Single file" - cell line-up in a row.
**Cell should not be cohesive -- [[lymphoma]] should briefly come to mind.
***primary lymphoma of the breast exists... but it is extremely rare.
*NO gland formation.
**If it forms glands... it is more likely NST.
*May have [[signet ring cell|signet ring]] morphology.
*NO [[desmoplastic reaction]], i.e. the stroma surrounding the tumour cells should look benign and undisturbed.
Note:
*Commonly have low grade nuclear features.
DDx:
*[[Invasive ductal carcinoma of the breast]] with lobular features.
*Poorly differentiated carcinoma.
*[[LCIS]].
*[[Malignant melanoma]].
===Subclassification===
*Classic lobular carcinoma.
**Low nuclear grade - NO significant variation of nucleus size.
*Pleomorphic lobular carcinoma.
**Significant nuclear atypia.
Note:
*Some pathologist grade lobular carcinoma like other types and avoid the term "pleomorphic lobular carcinoma."<ref>MUA. Jan 22, 2009.</ref>
Other variants:
*Histiocytoid.<ref name=pmid21398688>{{Cite journal  | last1 = Tan | first1 = PH. | last2 = Harada | first2 = O. | last3 = Thike | first3 = AA. | last4 = Tse | first4 = GM. | title = Histiocytoid breast carcinoma: an enigmatic lobular entity. | journal = J Clin Pathol | volume = 64 | issue = 8 | pages = 654-9 | month = Aug | year = 2011 | doi = 10.1136/jcp.2011.088930 | PMID = 21398688 }}</ref>
===Images===
<gallery>
Image:Lobular_carcinoma_-_low_mag.jpg | Lobular carcinoma - low mag. (WC/Nephron)
Image:Lobular_carcinoma_-_high_mag.jpg | Lobular carcinoma - high mag. (WC/Nephron)
Image:Lobular_carcinoma_-_high_mag.jpg | Lobular carcinoma - very high mag. (WC/Nephron)
</gallery>
<gallery>
Image:Breast_invasive_lobular_carcinoma_%281%29.jpg | Lobular carcinoma - 1 (WC)
Image:Breast_invasive_lobular_carcinoma_%282%29.jpg | Lobular carcinoma - 2 (WC)
</gallery>
==IHC==
Features:
*[[E-cadherin]] -ve.
*ER and PR +ve.
*HER2 -ve.
*CK7 +ve.
Others:
*CK20 -ve.
*Beta-catenin -ve/+ve (~46% completely negative<ref name=pmid11237489>{{cite journal |authors=Karayiannakis AJ, Nakopoulou L, Gakiopoulou H, Keramopoulos A, Davaris PS, Pignatelli M |title=Expression patterns of beta-catenin in in situ and invasive breast cancer |journal=Eur J Surg Oncol |volume=27 |issue=1 |pages=31–6 |date=February 2001 |pmid=11237489 |doi=10.1053/ejso.1999.1017 |url=}}</ref>).
==See also==
*[[Invasive breast cancer]].
*[[Signet ring cell carcinoma]].
==References==
{{Reflist|2}}
[[Category:Invasive breast cancer]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 19:26, 20 December 2021

Invasive lobular carcinoma
Diagnosis in short

Lobular carcinoma. H&E stain.
LM DDx invasive ductal carcinoma of the breast with lobular features, poorly differentiated carcinoma, LCIS
IHC E-cadherin -ve, usu. ER and PR +ve, HER2 -ve, CK7 +ve
Grossing notes breast grossing
Staging breast cancer staging
Site breast - see invasive breast cancer
Syndromes hereditary diffuse gastric cancer
Prevalence relatively common
Clin. DDx other breast tumours

Invasive lobular carcinoma, abbreviated ILC, is the second most common form of Invasive breast cancer.

It may be referred to as lobular carcinoma; however, this may lead to confusion with lobular carcinoma in situ.

General

  • May be associated with a CDH1 mutation - seen in diffuse type gastric cancer.[1][2]

Microscopic

Features:

  • "Single file" - cell line-up in a row.
    • Cell should not be cohesive -- lymphoma should briefly come to mind.
      • primary lymphoma of the breast exists... but it is extremely rare.
  • NO gland formation.
    • If it forms glands... it is more likely NST.
  • May have signet ring morphology.
  • NO desmoplastic reaction, i.e. the stroma surrounding the tumour cells should look benign and undisturbed.

Note:

  • Commonly have low grade nuclear features.

DDx:

Subclassification

  • Classic lobular carcinoma.
    • Low nuclear grade - NO significant variation of nucleus size.
  • Pleomorphic lobular carcinoma.
    • Significant nuclear atypia.

Note:

  • Some pathologist grade lobular carcinoma like other types and avoid the term "pleomorphic lobular carcinoma."[3]

Other variants:

  • Histiocytoid.[4]

Images

  • Lobular carcinoma - low mag. (WC/Nephron)

  • Lobular carcinoma - high mag. (WC/Nephron)

  • Lobular carcinoma - very high mag. (WC/Nephron)

  • Lobular carcinoma - 1 (WC)

  • Lobular carcinoma - 2 (WC)

IHC

Features:

Others:

  • CK20 -ve.
  • Beta-catenin -ve/+ve (~46% completely negative[5]).

See also

References

  1. ↑ URL: http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=33006. Accessed on: 19 April 2011.
  2. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 192090
  3. ↑ MUA. Jan 22, 2009.
  4. ↑ Tan, PH.; Harada, O.; Thike, AA.; Tse, GM. (Aug 2011). "Histiocytoid breast carcinoma: an enigmatic lobular entity.". J Clin Pathol 64 (8): 654-9. doi:10.1136/jcp.2011.088930. PMID 21398688.
  5. ↑ Karayiannakis AJ, Nakopoulou L, Gakiopoulou H, Keramopoulos A, Davaris PS, Pignatelli M (February 2001). "Expression patterns of beta-catenin in in situ and invasive breast cancer". Eur J Surg Oncol 27 (1): 31–6. doi:10.1053/ejso.1999.1017. PMID 11237489.
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