Breast - nonmalignant
Fibrocystic disease
Collagenous spherulosis of breast

Author: Hind Nassar, M.D. (see Authors page)

Revised: 31 July 2017, last major update May 2010

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Collagenous spherulosis [title] breast

Cite this page: Collagenous spherulosis of breast. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastcollageneousspherulosis.html. Accessed November 20th, 2017.
Definition / general
  • Rare benign change occurring in proliferative lesions (papilloma, florid ductal hyperplasia) and characterized by intraluminal spherules (Am J Surg Pathol 1987;11:411)
Terminology
  • Also described as "adenoid cystic hyperplasia"
Epidemiology
Etiology
  • The spherules consist of basement membrane material
Clinical features
  • Almost always an incidental finding, only rarely presents as a mass
  • Associated with intraductal papilloma, sclerosing adenosis, radial sclerosing lesions; also LCIS (Am J Surg Pathol 1995;19:1366)
Case reports
  • 48 year old woman with collagenous spherulosis in an adenomyoepithelioma of the breast (J Clin Pathol 2004;57:83)
  • 54 year old woman with collagenous spherulosis of the breast in association with in situ carcinoma (Pathologica 2002;94:317)
Treatment
  • Requires no treatment by itself but may be associated with malignancy
Gross description
  • Usually multifocal, 1 to 3 mm (not visible grossly)
Microscopic (histologic) description
  • Intraluminal clusters of eosinophilic or rarely basophilic ("mucinous spherulosis," Arch Pathol Lab Med 1999;123:626), collagen rich spherules within spaces, surrounded by flattened myoepithelial cells; spherules can calcify
  • Associated with LCIS (25%) and microcalcifications (25%, Am J Surg Pathol 2006;30:20)
Microscopic (histologic) images

Images hosted on PathOut server:

Courtesy of Dr. Mark R. Wick:

Cribriform architecture

Glands have a prominent fibrous stroma

Tubular adenosis with features within adenomyoepithelioma of collagenous spherulosis

PAS



Images hosted on other servers:

H&E

Tubular adenosis
with features within
adenomyoepithelioma
of collagenous spherulosis


Adenomyo-epithelioma with collagenous spherulosis

Adenoid cystic carcinoma vs. collagenous spherulosis

p63 and c-kit

Cytology description
  • Hyaline pink globules surrounded by benign myoepithelial cells in Giemsa stained smears (Cytopathology 2002;13:116)
  • Note: cytological evidence of spherulosis also suggests intraductal papilloma (Cytopathology 2010;21:157)
  • Mucinous spherulosis:
    • Cribriform structures with lightly basophilic material embedded in loosely mucinous acellular background
    • Intermediate to large, round hyaline spherules are naked or surrounded by myoepithelial cells
    • Diff - Quik stain shows fibrillary radial appearance (Diagn Cytopathol 2006;34:626)
Cytology images

Images hosted on PathOut server:

FNA

Positive stains
Negative stains
Electron microscopy description
  • Epithelial cells and myoepithelial cells plus associated basement membrane-like material (Breast J 2000;6:199)
Differential diagnosis