Collagenous spherulosis

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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
Site breast

Symptoms usu. asymptomatic
Prevalence uncommon
Prognosis benign
Treatment none required, usu. incidental finding

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.[1]

General

Gross

  • Usually small, typically 1-3 mm.[3]

Note:

  • May present as a larger mass.[4][5]

Microscopic

Features:[1][6]

  • 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

www:

See also

References

  1. 1.0 1.1 URL: http://surgpathcriteria.stanford.edu/breast/collspher/. Accessed on: 4 September 2011.
  2. 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. 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.
  4. 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.
  5. 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.
  6. URL: http://www.hsc.stonybrook.edu/breast-atlas/V-33.htm. Accessed on: 31 August 2011.