Breast
Other carcinoma subtypes, not WHO classified
Tubulolobular carcinoma
Author: Monika Roychowdhury, M.D.
Last author update: 1 August 2012
Last staff update: 16 August 2022
Copyright: 2001-2023, PathologyOutlines.com, Inc.
PubMed Search: tubulolobular carcinoma breast
Table of Contents
Definition / general | Terminology | Epidemiology | Prognostic factors | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Differential diagnosis | Additional referencesCite this page: Roychowdhury M. Tubulolobular carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastmalignanttubulolobular.html. Accessed September 28th, 2023.
Definition / general
- Rare, first described in 1977 (Hum Pathol 1977;8:679)
- Also occurs in anogenital region (Am J Surg Pathol 2006;30:1193)
- May be a well differentiated ductal carcinoma with a lobular growth pattern, or a tubular variant of lobular carcinoma (Virchows Arch 2006;448:500)
Terminology
- Not part of WHO breast classification
Epidemiology
- Median age 60 years, range 43 - 79 years
Prognostic factors
- Intermediate prognostic features between lobular and ductal carcinoma
- Best prognosis if unilateral and < 2 cm
- 25% present with greater than stage I disease, compared to 0% with tubular and 60% with lobular carcinoma (Mod Pathol 2007;20:130)
- Axillary nodal metastases in 13 - 43%
Case reports
- 69 year old woman with tubulobular carcinoma of the breast with grooved and cerebriform nuclei (Diagn Cytopathol 2011;39:54)
Gross description
- 0.5 to 2.5 cm, usually unilateral and 19 - 30% multifocal
Microscopic (histologic) description
- Typical areas of invasive lobular carcinoma with cords of single file cells, which merge with small, round to angulated tubules with minute or undetectable lumina
- Usually accompanied by DCIS, LCIS or both
- Tumors are usually well differentiated with small, round nuclei and indistinct nucleoli
- Stroma is densely collagenous with prominent elastosis
Microscopic (histologic) images
AFIP images
Arrow at tubules
Images hosted on other servers:
Small infiltrative glands
Tubulolobular breast immunophenotype
10x
20x
Mixed tubular and lobular components
Cytology description
- Single filing of cells and tubular structures
- Tumor cells have intracytoplasmic vacuoles, low nuclear grade and low mitotic activity
- Relatively clean background
- Variable apocrine cells (Acta Cytol 1996;40:465)
Positive stains
- E-cadherin (75 - 100%), 34betaE12 (93%) and catenins (alpha, beta or gamma-membranous staining in 100%)
- Usually ER+ and PR+
- Aberrant overexpression of CD133 / Prominin-1, collagen IV (basement membrane like pattern, Breast Care (Basel) 2008;3:423)
Differential diagnosis
- Mixed ductal and lobular carcinoma: may lack small, round to angulated tubules with minute or undetectable lumina; may lack prominent elastosis
Additional references
