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Breast-malignant, males, children
Adenosquamous carcinoma-low grade
Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.
Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)
Revised: 7 September 2009
Last major update: September 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Carcinoma with well developed tubule/gland formation mixed with widely dispersed solid nests of squamous cells
Terminology
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● Also called syringomatous carcinoma, adenocarcinoma with squamous differentiation
● See also mucoepidermoid carcinoma
Clinical
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● Uncommon; considered a rare variant of metaplastic breast carcinoma (AJSP 1987;11:351)
● May originate from an intraductal papillary tumor, or be associated with sclerosing adenosis, radial scar or ductal adenoma
● Recurs locally with conservative therapy, metastases unusual
● Difficult to diagnose by fine needle aspiration, core biopsy or frozen section (Histopathology 2006;49:603)
Gross description
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● Mean 2-3 cm, range 1-9 cm
● Hard, tan-yellow, infiltrative
Gross images
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Well circumscribed mass (AFIP)
Microscopic description
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● Resembles syringomatous adenoma of nipple; often originates from intraductal papillary tumor
● Has tadpole or comma shaped epithelial structures with inner epithelial cells and outer myoepithelial cells
● Also other areas of obvious squamous differentiation, desmoplastic stroma
● Often keratinizing squamous component
Micro images
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Angulated glands in desmoplastic stroma (Fig 1E)
AFIP Third Series
DCIS in large duct below and at arrows Invasive ductal elements with syringomatous
giving rise to adenosquamous carcinoma features in dense collagenous stroma
Neoplastic ductules around a lobule Neoplastic ductules with secretion and squamous area
Cytology description
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● Proliferating ductal cells and atypical squamous cells in the same cell clusters (Pathol Int 1997;47:264)
Positive stains
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● Variable myoepithelial marker expression (HHF35, calponin, S100, CK14, CK5/6, p63)
Negative stains
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● ER, PR (Pathol Annu 1994;29:181)
Electron microscopy
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● Glandular and squamous differentiation
● Squamous cells resemble acrosyringium of eccrine sweat gland
Differential diagnosis
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● Syringomatous adenoma of nipple - similar histology, but more superficial, involving nipple areolar complex; benign
Additional references
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● AJSP 1993;17:248, AJSP 1987;11:351, Stanford University
End of Breast – Malignant, Males, Children > Adenosquamous carcinoma-low grade
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