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Table of Contents
Definition / general | Epidemiology | Clinical features | Gross description | Microscopic (histologic) description | Cytology description | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Spindle cell ductal carcinoma in situ. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantspindlecelldcis.html. Accessed July 14th, 2017.
Definition / 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
Clinical features
- Nipple discharge, breast lump or mammographic abnormality
Gross description
- 3 to 41 mm
Microscopic (histologic) description
- 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
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