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
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

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:

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. 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.
  7. 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.