Breast malignant, males, children
Carcinoma subtypes
Lobular carcinoma - pleomorphic variant

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 28 October 2016, last major update August 2012

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Pleomorphic variant [title] lobular carcinoma

Cite this page: Lobular carcinoma - pleomorphic variant. website. Accessed February 20th, 2018.
Definition / general
  • Aggressive variant with high grade tumor cells
  • Mean age 57 years, range 24 - 92 years
Clinical features
Gross images

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Circumscribed tumor

Microscopic (histologic) description
  • Multifocal nodular aggregates of dyscohesive, pleomorphic, high-grade tumor cells in dense fibrotic breast parenchyma
  • Also single file and targetoid pattern of classic lobular carcinoma
  • Often signet ring cells (29%), globoid plasmacytoid cells with eosinophilic or foamy or vacuolated cytoplasm, high nuclear grade and often multiple nucleoli
  • Pleomorphic LCIS (45%) and classic LCIS (21%) often present
  • 3 - 10 mitoses per 10 HPF
  • Usually no microcalcifications, no duct formation present
Microscopic (histologic) images

Images hosted on PathOut server:

Signet ring type cells

Courtesy of Mark R. Wick, M.D.

Pagetoid spread, courtesy of Mark R. Wick, M.D.

In axillary, courtesy of Mark R. Wick, M.D.

Cadherin negative, courtesy of Mark R. Wick, M.D.

Images hosted on Flickr:

Courtesy of Dr. Semir Vranic

E cadherin- (residual
normal ducts), courtesy of
Dr. Semir Vranic

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Tumor cells

Tumor cells form single files

Pleomorphic tumor cells

Significant nuclear pleomorphism

With pleomorphic LCIS

E-cadherin negative




Cytology description
  • More cellular than classic lobular, large tumor cells with single filing, tumor cells have cytoplasmic vacuoles and pleomorphic nuclei (Cancer 1997;81:29)
  • May have apocrine features and resemble atypical mesothelial cells (Diagn Cytopathol 2008;36:657)
  • Ductal lavage: similar features, although less striking, including epithelial cells in small clusters, single-file or isolated; also nuclear atypia, cytoplasmic vacuoles and signet ring features (Acta Cytol 2008;52:207)
Cytology images

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Various images

Positive stains
Negative stains
Molecular / cytogenetics description
Molecular / cytogenetics images

Images hosted on PathOut server:

HER2 amp, courtesy of Mark R. Wick, M.D.

Differential diagnosis