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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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
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.