Collagenous spherulosis

Collagenous spherulosis is a benign change of the breast that can be confused for a malignancy.

It is also known as mucinous spherulosis, and spherulosis.

General

• Benign.
• Almost always an incidental finding.
• Can mimic ADH, cribriform DCIS, adenoid cystic carcinoma.
  • Epidemiologically, it may be associated with LCIS.

Microscopic

Features:

• 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:

• Atypical ductal hyperplasia.
• Cribriform DCIS.
• Adenoid cystic carcinoma of the breast.

Images

• 

  Collagenous spherulosis - intermed. mag. (WC/Nephron)

• 

  Collagenous spherulosis - high mag. (WC/Nephron)

• 

  Collagenous spherulosis - very high mag. (WC/Nephron)

www:

• Collagenous spherulosis (stonybrook.edu).

See also

• Breast pathology.