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Breast malignant, males, children

Carcinoma subtypes

Alveolar variant of lobular carcinoma

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 29 October 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Clinical features

● 4-15% of infiltrating lobular carcinoma cases (Br J Cancer 1989;60:605, Breast Cancer Res Treat 2012;133:713)
● Often postmenopausal women (Am J Clin Pathol 1986;85:1)
● May have poorer prognosis than classic lobular carcinoma (Cancer 2008;113:1511)

Case reports

● 74 year old woman with synchronous classic and alveolar lobular carcinomas (Am J Surg Pathol 2011;35:1743)

Micro description

● Sharply outlined (rounded) groups or nests of 20 or more cells, resembling alveoli, separated by delicate fibrovascular tissue
● May have osteoclast giant cells (Pathologica 1993;85:525)

Micro images

Uniform alveolar growth pattern

Tumor cells in discrete rounded aggregates separated by fibrous stroma (AFIP)

E-cadherin negative

May have retained E-cadherin staining (fig d/e)

Cytology description

● Rosette like pattern (Acta Cytol 2000;44:169)

Electron microscopy

● Tumor cells are similar to classic lobular tumors, but nests of cells are surrounded by elongated fibroblasts or myofibroblasts (Ultrastruct Pathol 1986;10:311)

Differential diagnosis

● Lobular carcinoma in situ - groups of cells have distinct myoepithelial layer and basement membrane
● Lymphoma - negative for epithelial markers, positive for lymphocytic markers

End of Breast malignant, males, children > Carcinoma subtypes > Alveolar variant of lobular carcinoma

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