Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Breast malignant, males, children

In situ carcinoma

Spindle cell ductal carcinoma in situ


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 26 January 2012, last major update January 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
=========================================================================

● May be a variant of neuroendocrine DCIS (Zhonghua Bing Li Xue Za Zhi 2006;35:13)
● Invasive tumors are considered a subset of metaplastic carcinoma

Epidemiology
=========================================================================

● Very rare (0.1% of breast carcinomas)
● Mean age 59 years

Symptoms
=========================================================================

● Nipple discharge, breast lump or mammographic abnormality

Gross description
=========================================================================

● 3 to 41 mm

Micro description / grading
=========================================================================

● 10-80% of DCIS cells are spindled; patterns are fascicular, streaming or papillary
● Solid growth pattern, lack of secondary spaces or peripheral fenestrations
● Usually low to intermediate nuclear grade, with variable necrosis and microinvasion (Histopathology 2004;45:343)

Cytology description
=========================================================================

● Predominantly clusters and a small population of single cells in a necrotic background
● Cells are mostly spindled, with minor population of epithelioid cells
● Cells have high N/C ratio with hyperchromatic and pleomorphic nuclei and prominent nucleoli
● Resembles metaplastic carcinoma (Acta Cytol 2005;49:323)

Positive stains
=========================================================================

● Usually synaptophysin or chromogranin
● ER, PR

Negative stains
=========================================================================

● HER2, HMW keratin, smooth muscle actin

Differential diagnosis
=========================================================================

● Florid hyperplasia: HMW keratin+
Intraductal papilloma: no atypia
● Metaplastic spindle cell tumors associated with fibrosclerotic lesions: Mod Pathol 2003;16:893
● Myoepithelial hyperplasia: p63+, S100+, smooth muscle actin+

Additional references
=========================================================================

Virchows Arch 2001;439:70

End of Breast malignant, males, children > In situ carcinoma > Spindle cell ductal carcinoma in situ


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).