Difference between revisions of "Collagenous spherulosis"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Collagenous_spherulosis_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Collagenous spherulosis. [[H&E stain]]. | |||
| Synonyms = mucinous spherulosis, spherulosis | |||
| Micro = tubular/cribriform architecture with intratubular eosinophilic material (classical arranged like the spokes of a wheel ("radial spikes"), granules ~ 1-2 micrometers), | |||
no mitotic activity, epithelial & myoepithelial - like benign breast | |||
| Subtypes = | |||
| LMDDx = [[atypical ductal hyperplasia]], [[cribriform DCIS]], [[adenoid cystic carcinoma of the breast]] | |||
| Stains = | |||
| IHC = CD10 +ve, ER +ve, PR +ve, p63 +ve, SMA +ve, CD117 -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[breast]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = usu. asymptomatic | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = none required, usu. incidental finding | |||
}} | |||
'''Collagenous spherulosis''' is a benign change of the [[breast]] that can be confused for a malignancy. | '''Collagenous spherulosis''' is a benign change of the [[breast]] that can be confused for a malignancy. | ||
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==General== | ==General== | ||
*Benign. | *Benign. | ||
* | *Usually an incidental (microscopic) finding.<ref name=pmid12523815>{{Cite journal | last1 = Jan | first1 = YJ. | last2 = Li | first2 = MC. | last3 = Ho | first3 = WL. | title = Collagenous spherulosis presenting as a mass of the breast. | journal = Zhonghua Yi Xue Za Zhi (Taipei) | volume = 65 | issue = 10 | pages = 494-7 | month = Oct | year = 2002 | doi = | PMID = 12523815 }}</ref> | ||
*Can mimic [[ADH]], [[cribriform DCIS]], [[adenoid cystic carcinoma of the breast|adenoid cystic carcinoma]].<ref name=pmid16330938>{{Cite journal | last1 = Resetkova | first1 = E. | last2 = Albarracin | first2 = C. | last3 = Sneige | first3 = N. | title = Collagenous spherulosis of breast: morphologic study of 59 cases and review of the literature. | journal = Am J Surg Pathol | volume = 30 | issue = 1 | pages = 20-7 | month = Jan | year = 2006 | doi = | PMID = 16330938 }}</ref> | *Can mimic [[ADH]], [[cribriform DCIS]], [[adenoid cystic carcinoma of the breast|adenoid cystic carcinoma]].<ref name=pmid16330938>{{Cite journal | last1 = Resetkova | first1 = E. | last2 = Albarracin | first2 = C. | last3 = Sneige | first3 = N. | title = Collagenous spherulosis of breast: morphologic study of 59 cases and review of the literature. | journal = Am J Surg Pathol | volume = 30 | issue = 1 | pages = 20-7 | month = Jan | year = 2006 | doi = | PMID = 16330938 }}</ref> | ||
**Epidemiologically, it may be associated with [[LCIS]].<ref name=pmid16330938/> | **Epidemiologically, it may be associated with [[LCIS]].<ref name=pmid16330938/> | ||
==Gross== | |||
*Usually small, typically 1-3 mm.<ref name=pmid16330938/> | |||
Note: | |||
*May present as a larger mass.<ref name=pmid18476887>{{Cite journal | last1 = Hill | first1 = P. | last2 = Cawson | first2 = J. | title = Collagenous spherulosis presenting as a mass lesion on imaging. | journal = Breast J | volume = 14 | issue = 3 | pages = 301-3 | month = | year = | doi = 10.1111/j.1524-4741.2008.00580.x | PMID = 18476887 }}</ref><ref>{{Cite journal | last1 = Jan | first1 = YJ. | last2 = Li | first2 = MC. | last3 = Ho | first3 = WL. | title = Collagenous spherulosis presenting as a mass of the breast. | journal = Zhonghua Yi Xue Za Zhi (Taipei) | volume = 65 | issue = 10 | pages = 494-7 | month = Oct | year = 2002 | doi = | PMID = 12523815 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
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www: | www: | ||
*[http://www.hsc.stonybrook.edu/breast-atlas/V-33.htm Collagenous spherulosis (stonybrook.edu)]. | *[http://www.hsc.stonybrook.edu/breast-atlas/V-33.htm Collagenous spherulosis (stonybrook.edu)]. | ||
==IHC== | |||
Features:<ref name=pmid22658481>{{Cite journal | last1 = Cabibi | first1 = D. | last2 = Giannone | first2 = AG. | last3 = Belmonte | first3 = B. | last4 = Aragona | first4 = F. | last5 = Aragona | first5 = F. | title = CD10 and HHF35 actin in the differential diagnosis between Collagenous spherulosis and adenoid-cystic carcinoma of the breast. | journal = Pathol Res Pract | volume = 208 | issue = 7 | pages = 405-9 | month = Jul | year = 2012 | doi = 10.1016/j.prp.2012.05.002 | PMID = 22658481 }}</ref> | |||
*CD10 +ve. ‡ | |||
*Muscle-specific actin +ve. ‡ | |||
*ER +ve. ‡ | |||
*PR +ve. ‡ | |||
*CD117 -ve. ‡ | |||
Others:<ref name=pmid22658481/> | |||
*SMA +ve. | |||
*p63 +ve. | |||
*CK 5/6 +ve. | |||
Note: | |||
* ‡ The opposite pattern is seen in ''adenoid cystic carcinoma''. | |||
==See also== | ==See also== | ||
*[[Breast pathology]]. | *[[Breast pathology]]. | ||
*[[Adenoid cystic carcinoma]]. | |||
==References== | ==References== | ||
Latest revision as of 20:56, 16 February 2014
Collagenous spherulosis is a benign change of the breast that can be confused for a malignancy.
| Collagenous spherulosis | |
|---|---|
| Diagnosis in short | |
 Collagenous spherulosis. H&E stain. | |
|
| |
| Synonyms | mucinous spherulosis, spherulosis |
|
| |
| LM |
tubular/cribriform architecture with intratubular eosinophilic material (classical arranged like the spokes of a wheel ("radial spikes"), granules ~ 1-2 micrometers), no mitotic activity, epithelial & myoepithelial - like benign breast |
| LM DDx | atypical ductal hyperplasia, cribriform DCIS, adenoid cystic carcinoma of the breast |
| IHC | CD10 +ve, ER +ve, PR +ve, p63 +ve, SMA +ve, CD117 -ve |
| Site | breast |
|
| |
| Symptoms | usu. asymptomatic |
| Prevalence | uncommon |
| Prognosis | benign |
| Treatment | none required, usu. incidental finding |
It is also known as mucinous spherulosis, and spherulosis.[1]
General
- Benign.
- Usually an incidental (microscopic) finding.[2]
- Can mimic ADH, cribriform DCIS, adenoid cystic carcinoma.[3]
Gross
- Usually small, typically 1-3 mm.[3]
Note:
Microscopic
- Tubular/cribriform architecture.
- Intratubular eosinophilic material - key feature.
- Classical: Arranged like the spokes of a wheel ("radial spikes").
- Atypical: Granules ~ 1-2 micrometers.
- No mitotic activity.
- Two cells populations (epithelial & myoepithelial) - like a well-behaved breast gland.
Notes:
- Usually small lesions: < 50 spherules per lesion, <100 micrometers.
- May be multifocal.
- +/-Calcifications - may prompt biopsy.
DDx:
Images
Collagenous spherulosis - intermed. mag. (WC/Nephron)
Collagenous spherulosis - high mag. (WC/Nephron)
Collagenous spherulosis - very high mag. (WC/Nephron)
www:
IHC
Features:[7]
- CD10 +ve. ‡
- Muscle-specific actin +ve. ‡
- ER +ve. ‡
- PR +ve. ‡
- CD117 -ve. ‡
Others:[7]
- SMA +ve.
- p63 +ve.
- CK 5/6 +ve.
Note:
- ‡ The opposite pattern is seen in adenoid cystic carcinoma.
See also
References
- ↑ 1.0 1.1 URL: http://surgpathcriteria.stanford.edu/breast/collspher/. Accessed on: 4 September 2011.
- ↑ Jan, YJ.; Li, MC.; Ho, WL. (Oct 2002). "Collagenous spherulosis presenting as a mass of the breast.". Zhonghua Yi Xue Za Zhi (Taipei) 65 (10): 494-7. PMID 12523815.
- ↑ 3.0 3.1 3.2 Resetkova, E.; Albarracin, C.; Sneige, N. (Jan 2006). "Collagenous spherulosis of breast: morphologic study of 59 cases and review of the literature.". Am J Surg Pathol 30 (1): 20-7. PMID 16330938.
- ↑ Hill, P.; Cawson, J.. "Collagenous spherulosis presenting as a mass lesion on imaging.". Breast J 14 (3): 301-3. doi:10.1111/j.1524-4741.2008.00580.x. PMID 18476887.
- ↑ Jan, YJ.; Li, MC.; Ho, WL. (Oct 2002). "Collagenous spherulosis presenting as a mass of the breast.". Zhonghua Yi Xue Za Zhi (Taipei) 65 (10): 494-7. PMID 12523815.
- ↑ URL: http://www.hsc.stonybrook.edu/breast-atlas/V-33.htm. Accessed on: 31 August 2011.
- ↑ 7.0 7.1 Cabibi, D.; Giannone, AG.; Belmonte, B.; Aragona, F.; Aragona, F. (Jul 2012). "CD10 and HHF35 actin in the differential diagnosis between Collagenous spherulosis and adenoid-cystic carcinoma of the breast.". Pathol Res Pract 208 (7): 405-9. doi:10.1016/j.prp.2012.05.002. PMID 22658481.