Advertisement
Advertisement
Table of Contents
Definition / general | Clinical features | Prognostic factors | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Electron microscopy description | Electron microscopy images | Differential diagnosis | Additional referencesCite this page: Lipid rich carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantlipidrich.html. Accessed July 14th, 2017.
Definition / general
- 90%+ cells have prominent intracytoplasmic neutral lipid
Clinical features
- 1% - 2% of breast carcinomas
- Axillary metastases may resemble histiocytes
Prognostic factors
- Poor prognosis due to frequent (70%) nodal metastases at presentation
Case reports
- 53 year old woman (Acta Chir Belg 2008;108:115)
- 55 year old man (Pathology 1995;27:280)
- 56 year old woman with focal chondroid metaplasia in tumor (Pathol Int 1998;48:912)
- 62 year old woman (Arch Pathol Lab Med 2003;127:e396)
- 78 year old woman with solid alveolar pattern in tumor (Breast Cancer 1998;5:171)
Gross description
- Lobulated, variable circumscription, firm
- 1 to 15 cm
Microscopic (histologic) description
- Nests, cords and sheets of large polygonal cells with foamy or vacuolated cytoplasm containing lipid
- May resemble clear cells or lipoblasts
- Irregular nuclei with coarse chromatin, moderate atypia, prominent nucleoli
- Other patterns are large pleomorphic cells in alveolar pattern with hobnail appearance, oncocytic or apocrine type change
Microscopic (histologic) images
Images hosted on PathOut server:
Images hosted on other servers:
Polygonal tumor cells
with distinct cell borders
and variable cytoplasmic
clearing (AFIP)
Images hosted on other servers:
Fig 1: tumor with pushing borders and lymphoplasmacytic and eosinophilic infiltrate (arrow: high grade comedo DCIS)
Fig 2: tumor composed of sheets and cords of large polyhedral
cells with ill defined borders, fine granular, eosinophilic
cytoplasm and large nuclei with prominent nucleoli and coarse chromatin
Fig 3: also large clear cells with foamy or vacuolated cytoplasm
Fig 4: axillary nodal metastasis
Positive stains
- Lipid stains (Sudan black, Oil red O on fresh tissue)
- HER2 (71%+, Tumori 2008;94:342, Ann Diagn Pathol 2011;15:225)
Electron microscopy description
- Numerous intracytoplasmic non membrane bound lipid droplets, often within autophagocytic vacuoles
- No evidence of lipid synthesis by rough ER or Golgi complexes (Virchows Arch A Pathol Anat Histopathol 1988;413:381)
Electron microscopy images
Images hosted on PathOut server:
Luminal microvilli, lipid droplets and mitochondria
Differential diagnosis
- Apocrine carcinoma: uniformly granular and eosinophilic cytoplasm, GCDFP-15+, no lipid
- Glycogen rich carcinoma: clear cytoplasm, secretions are glycogen (PAS+), not lipid
- Oncocytic carcinoma: granular and markedly eosinophilic cytoplasm, no lipid
- Secretory carcinoma: low grade, PASd+ secretions, no lipid
- Xanthogranulomatous mastitis (on core biopsy): not invasive, cells are CD68+, alpha-1-antitrypsin+ histiocytes (Pathol Int 2009;59:234)
Additional references
Advertisement
