Breast

Other carcinoma subtypes, WHO classified

Apocrine



Topic Completed: 1 March 2012

Minor changes: 29 April 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed search: Apocrine carcinoma [title] breast

Monika Roychowdhury, M.D.
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Cite this page: Roychowdhury M. Apocrine. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastmalignantapocrine.html. Accessed October 16th, 2021.
Definition / general
  • > 90% of tumor cells have cytologic or immunohistochemical features of apocrine cells
  • Rare, 1% - 4% of all breast carcinomas
Prognostic factors
Case reports
  • 71 year old woman with apocrine adenocarcinoma of the nipple (Cases J 2008;1:88)
  • 84 year old woman had a total mastectomy with axillary dissection for a breast nodule (Case #68)
Gross description
Microscopic (histologic) description
  • Tumor cells have distinct cell margins, abundant acidophilic cytoplasm with eosinophilic granules, central to eccentric vesicular nuclei with prominent nucleoli
  • May have glandular differentiation with apocrine snouts and prominent nucloeoli
  • Limit diagnosis to tumors with widespread apocrine change and obvious malignancy
  • Type A cells: abundant granular and intensely eosinophilic cytoplasm, granules are PAS+ diastase resistant, nuclei vary from globoid with prominent nucleoli to hyperchromatic
  • Type B cells: abundant cytoplasm with fine empty vacuoles, creating a foamy appearance resembling histiocytes, nuclei are similar to type A cells
  • Exclude: cases with clear cells of any type in any amount; other subtypes including tubular, lobular, mucinous, invasive micropapillary or medullary
Microscopic (histologic) images
Scroll to see all images.


Case #68

GCDFP-15

BCL2 negative


Contributed by Dr. Mark R. Wick


AFIP images

Solid growth

Histiocytoid variant with isolated
cells resembling histiocytes
in desmoplastic stroma,
resembles granular cell tumor




Contributed by Dr. Semir Vranic

10x

20x

GCDFP-15

AR expression


Estrogen receptor

HER2

HER2 gene, CISH 2





Images hosted on other servers:

Abundant cytoplasm with distinct cell margins

Cytoplasm is granular, nuclei are round

Cells have abundant cytoplasm with distinct cell margins


Cytoplasm is granular, nuclei are round with prominent nucleoli


With apocrine DCIS

H&E

GCDFP-15

Cytology images

Contributed by Areej M. Al Nemer, M.D.
Suspicious nipple discharge

Suspicious nipple discharge

Positive stains
Negative stains
Electron microscopy description
  • Prominent mitochondria, some with abnormal cristae
  • Large membrane bound vesicles with dense homogenous osmophilic cores
Electron microscopy images

AFIP images

Smooth and rough
endoplasmic
reticulum,
dense nucleoli

Cytokeratin fila-
ments (arrow), lipid
droplets, mito-
chondria, lysosomes

Cytoplasm contains numerous
lysosomes, lipid droplets,
dilated mitochondria and
vesicular endoplasmic reticulum



Images hosted on other servers:

Cytoplasm rich in organelles

Electron dense
granules, condensed, at
secretory pole of cell

Molecular / cytogenetics description
  • Form a distinct, even if heterogeneous, molecular subgroup of breast carcinomas that recapitulate the phenotype of apocrine sweat glands (Mol Oncol 2009;3:220)
  • Abnormalities at 7q (codes for GCDFP-15 and prolactin inducible protein)
  • Also loss of heterozygosity for p53 gene, VHL (3p25) gene, NB gene (1p35-36), PKD1/TSC2 gene at 16p13 (Mod Pathol 1999;12:1083)
Differential diagnosis
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