Collagenous spherulosis
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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.