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Invasive lobular carcinoma (view source)
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{{ 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]] | ||