Difference between revisions of "Invasive lobular carcinoma"

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| LMDDx      = [[invasive ductal carcinoma of the breast]] with lobular features, poorly differentiated carcinoma, [[LCIS]]
| LMDDx      = [[invasive ductal carcinoma of the breast]] with lobular features, poorly differentiated carcinoma, [[LCIS]]
| Stains    =
| Stains    =
| IHC        = E-cadherin -ve, usu. ER and PR +ve, HER2 -ve, CK7 +ve
| IHC        = [[E-cadherin]] -ve, usu. ER and PR +ve, HER2 -ve, [[CK7]] +ve
| EM        =
| EM        =
| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      =
| Gross      =
| Grossing  =
| Grossing  = [[breast grossing]]
| Staging    = [[breast cancer staging]]
| Site      = [[breast]] - see ''[[invasive breast cancer]]''
| Site      = [[breast]] - see ''[[invasive breast cancer]]''
| Assdx      =
| Assdx      =
| Syndromes  = hereditary diffuse gastric cancer syndrome
| Syndromes  = [[hereditary diffuse gastric cancer]]
| Clinicalhx =
| Clinicalhx =
| Signs      =
| Signs      =
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*Poorly differentiated carcinoma.
*Poorly differentiated carcinoma.
*[[LCIS]].
*[[LCIS]].
 
*[[Malignant melanoma]].
===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>
 
More [[WC]] images:
*[http://commons.wikimedia.org/wiki/File:Breast_invasive_lobular_carcinoma_%281%29.jpg Lobular carcinoma - 1 (WC)].
*[http://commons.wikimedia.org/wiki/File:Breast_invasive_lobular_carcinoma_%282%29.jpg Lobular carcinoma - 2 (WC)].


===Subclassification===
===Subclassification===
Line 74: Line 65:
Note:  
Note:  
*Some pathologist grade lobular carcinoma like other types and avoid the term "pleomorphic lobular carcinoma."<ref>MUA. Jan 22, 2009.</ref>
*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==
==IHC==
Features:
Features:
*E-cadherin -ve.
*[[E-cadherin]] -ve.
*ER and PR +ve.
*ER and PR +ve.
*HER2 -ve.
*HER2 -ve.
Line 84: Line 89:
Others:
Others:
*CK20 -ve.
*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==
==See also==

Latest revision as of 19:26, 20 December 2021

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

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

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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